NPIMap

Individual provider Active NPI

Claudine Gillison

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1013126317
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD431115 Issued in PA
Practice address
2532 Farragut Dr
Springfield, IL 62704-1433
Phone
(217) 528-7541
NPI assigned
May 22, 2007
Last updated
May 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD431115 PA Primary

Addresses

Primary practice location

2532 Farragut Dr
Springfield, IL 62704-1433

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address claudinegillison@sfc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518001336 IL Practitioner - Pediatric Medicine 5496834277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD431115PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Apr 16, 2016 Accepting new patients
N.B. Krishnappa M.D. F.a.a.P. Inc Pediatrics Past Accepting new patients

Locations

1025 S 6th St
Springfield, IL 62703

2532 Farragut Dr
Springfield, IL 62704
Phone (217) 787-9424

3501 Old Jacksonville Rd
Springfield, IL 62711
Phone (217) 960-8193

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: claudine.gillison.1@28977.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jan 1, 2014
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jan 1, 2014
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jan 1, 2014
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jan 1, 2014
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jan 1, 2014

Owned or controlled facilities with NPI records 5

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1013126317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 FARRAGUT DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041433",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISON",
        "first_name": "CLAUDINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD431115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "claudinegillison@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2532 Farragut Dr",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627041433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.