Central Collinsville Health Center – Federally Qualified Health Center (FQHC), NPI 1750530424

Central Collinsville Health Center is a healthcare provider. based in Sauget, Illinois. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Central Collinsville Health Center is 1750530424

Main info

Organization
Name
Central Collinsville Health Center
NPI
1750530424
Phone
(618) 332-0694
Address
2041 GOOSE LAKE RD
Authorized Official
MR. LARRY MCCULLEY CHIEF EXECUTIVE OFFICER
Enumeration Date
17 September 2008
Last Update Date
29 July 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness90
Years active:17State licenses:0Digital endpoints

Provider Addresses for Central Collinsville Health Center

  • Goose Lake, Sauget, Saint Clair County, Illinois, 62207, United States

    SAUGET, IL 622062822

    Phone: (618) 332-0694

    Fax: (618) 332-2487

    Type: Mailing

  • 1215 VANDALIA AVENUE

    COLLINSVILLE, IL 62234

    Phone: (618) 397-3303

    Fax: (618) 397-7802

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090716000602OFederally Qualified Health Center (Fqhc)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62206)

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Reviews

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Frequently asked questions

Does Central Collinsville Health Center have a public NPI I can cite?
Public records show Central Collinsville Health Center under NPI 1750530424.
Is Central Collinsville Health Center currently accepting referrals based on NPI status?
Registry metadata lists Central Collinsville Health Center as active.
Which specialty label fits Central Collinsville Health Center?
NPPES ties Central Collinsville Health Center to Federally Qualified Health Center (FQHC) in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Central Collinsville Health Center tied to Sauget, Illinois?
If you are local to Sauget, Illinois, Central Collinsville Health Center may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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