NPIMap

Individual provider Active NPI

John W Nugent, PAC

  • Physician Assistant
  • Herrin, IL
National Provider Identifier
1033224654
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001449 Issued in IL
Practice address
510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone
(618) 997-6800
Fax
(618) 998-9124
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001449 IL Primary
Emergency Medicine Physician 207P00000X 085.001449 IL

Addresses

Primary practice location

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948

Mailing address

510 Lincoln Drive
Southern Orthopedic Associates SC
Herrin, IL 62948
Phone (618) 997-6800

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
I20050418001038 IL Practitioner - Physician Assistant 9234177510 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Southern Orthopedic Associates SCGroup PAC ID 8921095514, 29 clinicians

Practice addresses (Care Compare)

1104 W Main St
Benton, IL 62812-1565
Phone (618) 439-3399

2421 W Main St
Suite a
Carbondale, IL 62901-1039
Phone (618) 529-3201

303 NW 11TH St
Fairfield, IL 62837-1203
Phone (618) 847-8346

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

510 Lincoln Dr
Herrin, IL 62948-3774

510 Lincoln Dr
Herrin, IL 62948-6334
Phone (618) 997-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.56 of 100Reported as group
Quality
83.23
Promoting interoperability
100
Improvement activities
40
Cost
75.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.001449ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Memorial Hospital Association CurrentSince Mar 4, 2026 Accepting new patients
Fairfield Memorial Hospital Association CurrentSince Mar 4, 2026 Accepting new patients
Southern Orthopedic Associates SC Physician Assistant CurrentSince May 10, 2005 Accepting new patients

Locations

303 NW 11th St
Fairfield, IL 62837
Phone (618) 842-2611

510 Lincoln Dr
Herrin, IL 62948
Phone (618) 997-3100

Interoperability endpoints

  • Direct secure messaging: nugentj@yourcarecommunity.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/11356/brand/1/csg/161/fhir/r4
  • Direct secure messaging: jnugent420516@direct.deaconess.com

Organizations & group practices 4

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1033224654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DRIVE",
            "address_2": "SOUTHERN ORTHOPEDIC ASSOCIATES SC",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001449",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "085.001449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.