Individual provider Active NPI

Kevin B Claffey, M.D.

  • Surgery Physician
  • Mount Vernon, IL
National Provider Identifier
1144226085
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
4218 Lincolnshire Dr
Mount Vernon, IL 62864-2156
Phone
(618) 242-8480
Fax
(618) 242-8499
NPI assigned
Jun 24, 2005
Reactivated
Jul 1, 2005
Last updated
Feb 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

4218 Lincolnshire Dr
Mount Vernon, IL 62864-2156

Mailing address

4218 Lincolnshire Dr
PO Box 968
Mount Vernon, IL 62864-2156
Phone (618) 242-8480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421000578 IL Practitioner - General Surgery 0446203681 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Hahnemann University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Township HospitalGroup PAC ID 0840195277, 26 clinicians

Practice addresses (Care Compare)

1201 Ricker Rd
Salem, IL 62881-4263
Phone 61854831948188

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Jan 14, 2023 Accepting new patients
Salem Township Hospital CurrentSince Feb 6, 2023 Accepting new patients
Salem Township Hospital CurrentSince Feb 6, 2023 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Surgery CurrentSince Apr 5, 2005 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Surgery Current Accepting new patients
Good Samaritan Regional Health Center Past Accepting new patients
Salem Township Hospital Past Accepting new patients
Heartland Rural Healthcare, LLC Past Accepting new patients
Salem Township Hospital Past Accepting new patients

Locations

211 S Lincoln Blvd
Centralia, IL 62801
Phone (618) 436-6057

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

3331 W Deyoung St
Marion, IL 62959
Phone (618) 985-9140

3331 W Deyoung St
Ste 109
Marion, IL 62959
Phone (618) 242-0672

3331 W Deyoung St
Ste 305
Marion, IL 62959
Phone (618) 998-7089

3333 W Deyoung St
Ste 205
Marion, IL 62959
Phone (618) 998-1161

3333 W Deyoung St
Ste 302
Marion, IL 62959

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

2 Good Samaritan Way
Ste 235
Mount Vernon, IL 62864
Phone (618) 899-3970

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

209 Crossroads Pl
Mount Vernon, IL 62864
Phone (618) 242-4554

4218 Lincolnshire Dr
Mount Vernon, IL 62864
Phone (618) 242-8480

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

Interoperability endpoints

  • Direct secure messaging: kclaff03@yourcarecommunity.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1144226085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 LINCOLNSHIRE DR",
            "address_2": "PO BOX 968",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642156",
            "telephone_number": "618-242-8480",
            "fax_number": "618-242-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 LINCOLNSHIRE DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642156",
            "telephone_number": "618-242-8480",
            "fax_number": "618-242-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAFFEY",
        "first_name": "KEVIN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-02-07",
        "deactivation_date": "2005-06-24",
        "reactivation_date": "2005-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.