NPIMap

Organization Active NPI

Christopher Greater Area Rural Health Planning Corporation

Doing business as Fairfield Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Fairfield, IL
National Provider Identifier
1902170632
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
Fairfield Community Health Center
Practice address
1007 W Main St
Fairfield, IL 62837-2308
Phone
(618) 842-4470
Fax
(618) 842-3437
NPI assigned
Feb 27, 2012
Last updated
Jan 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly A. Mitroka
Title
Ceo
Phone
(618) 724-2436

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Physician Assistant 363A00000X NU
Counselor 101Y00000X NU
Family Medicine Physician 207Q00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

1007 W Main St
Fairfield, IL 62837-2308

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401

Other names 1

  • Fairfield Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040109000561 IL Part B Supplier - Clinic/Group Practice 8224947387 Receives reassigned benefits from 71 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shawneetown, IL; Sesser, IL; Mount Vernon, IL; Johnston City, IL; Flora, IL; Fairfield, IL; Eldorado, IL; Du Quoin, IL…
O20120320000084 IL Part A Provider - Federally Qualified Health Center (FQHC) 8224947387 Practice locations: Fairfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902170632. Details of each certification follow.

Federally qualified health center certification: CCN 141158

Legal name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
FAIRFIELD COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2012
Last certification
Apr 5, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 8, 1977 in IL
Enrollment address
1007 W Main St
Fairfield, IL 62837-2308

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0873963Fairfield Community Health Center (D/B/a)1007 W Main St, Fairfield, IL 62837Provider-performed microscopyMar 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Christopher Rural Healt19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

119 Gas Plant Rd
Du Quoin, IL 62832
Phone (618) 542-8702

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Hosselton Individual OtherBoard Member Mar 1, 1998
Ruth Stanford Individual OtherBoard Member Mar 1, 1999
Paul J Cruz Individual OtherBoard Member Mar 1, 2016
Marian Smith-Furlow Individual Other Mar 1, 2013
Kimberly a. Mitroka Individual Corporate OfficerCeo Apr 2, 2012
Corporate DirectorCeo/Board Member Apr 2, 2012
W-2 Managing EmployeeCeo Apr 2, 2012
Operational/Managerial ControlCeo Apr 2, 2012
Thomas Konopasek Individual OtherBoard Member Mar 1, 2015
Richard Schablowsky Individual OtherBoard Member Mar 1, 2004
Lisa Hopkins Individual OtherBoard Member Mar 23, 2008
Gerald Hearring Individual OtherBoard Member Mar 1, 2003

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mt. Vernon Community Health CenterMt Vernon, IL, CCN 141022 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2005
Johnston City Community Health CenterJohnston City, IL, CCN 141065 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2009
Crhpc Comprehensive Behavioral Health ServicesDu Quoin, IL, CCN 781074 Federally qualified health center Operational/Managerial Control (100%) Jul 8, 1977

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1902170632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W MAIN ST",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372308",
            "telephone_number": "618-842-4470",
            "fax_number": "618-842-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "MITROKA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-724-2436"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairfield Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, IL

Sources for this page

Verify at the official NPI Registry.