Preston Simpson, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.022556 Issued in IL

Practice address

403 Municipal Dr
Carterville, IL 62918-2042

Phone

(855) 608-3560

Fax

(618) 956-9349

NPI assigned

Mar 4, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ultacare Medical PLLC

  • Family Medicine Physician
  • New Tazewell, TN
  • NPI 1225141492

  Clinical, IL

  Medicare reassignment Care Compare group NPD
• Centerstone of Illinois, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1053455667
  Medicare reassignment NPD
• Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Alton, IL
  • NPI 1033570262
  NPD

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1083249635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MUNICIPAL DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629182042",
            "telephone_number": "855-608-3560",
            "fax_number": "618-956-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "PRESTON",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Si Vitality Specialty Clinic LLC
• Si Vitality Wellness Center
• Christina Sigler, BS
• Siloam LLC
• Brent Simpson
• Solutions Counseling & Education Inc
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services

• Clinical Social Worker in Carterville, IL
• Providers in Carterville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.