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CHRISTIAN ACTIVITY HEALTH CENTER
NPI 1619127289
Clinic/Center - Federally Qualified Health Center (FQHC) in East Saint Louis, IL

Active since September 19, 2008
540 N 6TH ST, EAST SAINT LOUIS, IL 62201(618) 397-3303(618) 397-3303 Get Directions Write a Review

NPPES record last updated: September 19, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Christian Activity Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRISTIAN ACTIVITY HEALTH CENTER (NPI 1619127289) is a healthcare organization registered as a federally qualified health center (fqhc) in East Saint Louis, Illinois and active in the NPI registry since September 2008. The organization lists Larry Mcculley, Coo, as its authorized official.

NPPES Registry Identity

NPI1619127289
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Location Address540 N 6TH STEast Saint Louis, IL 62201-1320
Mailing Address8080 State StEast Saint Louis, IL 62203-1808 · (618) 397-3303 · Fax (618) 397-7802
Phone(618) 397-3303
Fax(618) 397-3303
Organization SubpartNo
Authorized OfficialLarry McculleyCoo · (618) 332-0694
Enumeration DateSeptember 19, 2008
✔ NPI 1619127289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedFamily MedicineTaxonomy 207Q00000X
540 N 6TH ST, East Saint Louis, IL 62201
Open in Google Maps ↗

Other Names 1

Doing Business AsChristian Activity Health Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Christian Activity Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

164

Medicare enrollment records show 164 clinicians reassign Medicare billing to Christian Activity Health Center, which bills Medicare for the services they deliver. Of these, 48 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 15

Nurse Practitioner57
Family Practice43
Internal Medicine16
Psychiatry12
Clinical Social Worker9
Mental Health Counselor6
Obstetrics/Gynecology5
Cardiovascular Disease (Cardiology)3
7 other specialties13

Nearest to this location (20)

See all 164
Christopher Johnson, MD
Psychiatry
NPI 1205975448
100 N 8TH ST
East Saint Louis, IL 62201
(618) 271-0130
✔ PECOS✔ Accepts Medicare0.7 mi
Christopher Loynd, D.O.
Psychiatry
NPI 1003965955
100 N 8TH ST
East Saint Louis, IL 62201
(618) 271-0130
✔ PECOS✔ Accepts Medicare0.7 mi
Tierra Smith, FNP-BC
Nurse Practitioner
NPI 1316647753
100 N 8TH ST STE 120
East Saint Louis, IL 62201
(618) 274-9105
✔ PECOS✔ Accepts Medicare0.7 mi
Natascha Jeffries, FNP, PMHNP
Nurse Practitioner
NPI 1629409362
100 N 8TH ST STE 120
East Saint Louis, IL 62201
(618) 274-9105
✔ PECOS✔ Accepts Medicare0.7 mi
Narsimha Muddasani, M.D.
Psychiatry
NPI 1548366263
100 N 8TH ST
East Saint Louis, IL 62201
(618) 271-0130
✔ PECOS✔ Accepts Medicare0.8 mi
Dolores Gunn, M.D.
Family Practice
NPI 1740247360
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-9191
✔ PECOS✔ Accepts Medicare1.2 mi
Kayla Pryor, APRN
Nurse Practitioner
NPI 1093345415
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-0204
✔ PECOS✔ Accepts Medicare1.2 mi
Miguel Granger, MD
Family Practice
NPI 1265527998
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-9191
✔ PECOS✔ Accepts Medicare1.2 mi
Yolanda Hoag, ACNPC-AG
Nurse Practitioner
NPI 1053815423
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-9191
✔ PECOS✔ Accepts Medicare1.2 mi
Denise Krone, FNP,BC
Nurse Practitioner
NPI 1902163942
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-0204
✔ PECOS✔ Accepts Medicare1.2 mi
Jordan Marshall, MD
General Practice
NPI 1396188025
2001 STATE ST
East Saint Louis, IL 62205
(618) 271-0204
✔ PECOS✔ Accepts Medicare1.2 mi
Bassam Albarcha, MD,FACP
Internal Medicine
NPI 1821184193
915 N GRAND BLVD
Saint Louis, MO 63106
(314) 652-4100
✔ PECOS✔ Accepts Medicare4.5 mi
Alfred Johnson, MD
Family Practice
NPI 1144316431
6010 BOND AVE
East Saint Louis, IL 62207
(618) 337-8153
✔ PECOS✔ Accepts Medicare4.7 mi
Kalyani Gavini, M.D.
Psychiatry
NPI 1730214206
6000 BOND AVE
Centreville, IL 62207
(618) 332-2083
✔ PECOS✔ Accepts Medicare4.7 mi
Bhawna Sharma, M.D
Psychiatry
NPI 1134546690
6000 BOND AVE
Centreville, IL 62207
(618) 332-2083
✔ PECOS✔ Accepts Medicare4.7 mi
Tyler Thurman, LCPC
Mental Health Counselor
NPI 1053587279
6000 BOND AVE
Centreville, IL 62207
(618) 332-2083
✔ PECOS✔ Accepts Medicare4.7 mi
Oladele Ajao, MD
Internal Medicine
NPI 1700829025
2100 MADISON AVE
Granite City, IL 62040
(618) 452-3301
✔ PECOS✔ Accepts Medicare4.9 mi
Sang Nelson, LCSW
Clinical Social Worker
NPI 1821177056
2100 MADISON AVE STE. 303
Granite City, IL 62040
(618) 452-4969
✔ PECOS4.9 mi
James Fernandez, M.D.
Otolaryngology
NPI 1528037280
2120 MADISON AVE SUITE 200
Granite City, IL 62040
(618) 451-1800
✔ PECOS✔ Accepts Medicare4.9 mi
Michael Adams, MD
Internal Medicine
NPI 1851383301
2166 MADISON AVE
Granite City, IL 62040
(618) 452-3301
✔ PECOS✔ Accepts Medicare5.0 mi
See all 164 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois Healthcare Foundation Inc's NPI number?

The NPI number for Southern Illinois Healthcare Foundation Inc is 1619127289. It was assigned to this organization in the NPPES registry on September 19, 2008. The provider is doing business as Christian Activity Health Center.

Where is Southern Illinois Healthcare Foundation Inc located?

Southern Illinois Healthcare Foundation Inc is located at 540 N 6th St, East Saint Louis, IL 62201. The listed phone number is (618) 397-3303.

What is Southern Illinois Healthcare Foundation Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Southern Illinois Healthcare Foundation Inc enrolled in Medicare?

Yes. Southern Illinois Healthcare Foundation Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Illinois Healthcare Foundation Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 164 clinicians in 15 Medicare specialties reassign their Medicare billing to Southern Illinois Healthcare Foundation Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (57), Family Practice (43) and Internal Medicine (16). Of these, 48 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southern Illinois Healthcare Foundation Inc was last updated on September 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.