Fairfield Community Health Center – Federally Qualified Health Center (FQHC), NPI 1902170632

Fairfield Community Health Center is a healthcare provider. based in Fairfield, Illinois. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Fairfield Community Health Center is 1902170632

Main info

Organization
Name
Fairfield Community Health Center
NPI
1902170632
Phone
(618) 842-4470
Address
209 NW 11TH ST
Authorized Official
KIMBERLY A. MITROKA CEO
Enumeration Date
27 February 2012
Last Update Date
30 January 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness90
Years active:14State licenses:0Digital endpoints

Provider Addresses for Fairfield Community Health Center

  • 209 NW 11TH ST

    FAIRFIELD, IL 628371218

    Phone: (618) 842-4470

    Fax: (618) 842-3437

    Type: Location

  • PO BOX 155

    CHRISTOPHER, IL 628220155

    Phone: (618) 724-2401

    Fax: (618) 724-4628

    Type: Mailing

  • 1007 W MAIN ST

    FAIRFIELD, IL 628372308

    Phone: (618) 842-4470

    Fax: (618) 842-3437

    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: 2012-03-20

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
O20120320000084OFederally 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 62837)

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Reviews

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Frequently asked questions

What federal number belongs to Fairfield Community Health Center?
The federal identifier for Fairfield Community Health Center is NPI 1902170632.
Is Fairfield Community Health Center currently active in the NPI registry?
CMS-published data lists Fairfield Community Health Center as an active registrant.
What kind of provider is Fairfield Community Health Center?
The page reflects Federally Qualified Health Center (FQHC) for Fairfield Community Health Center. Clinical services aligned with this taxonomy classification.
Where does public data place Fairfield Community Health Center?
The snapshot lists Fairfield, Illinois for Fairfield Community Health Center; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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