Individual provider Active NPI

Clelland James-Henry Chatman, M.D.

  • Diagnostic Radiology Physician
  • Bridgeton, MO
National Provider Identifier
1174933022
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036158981 Issued in IL
Practice address
12303 De Paul Dr
Bridgeton, MO 63044
Phone
(314) 770-9393
Fax
(314) 770-9997
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036158981 IL Primary
Nuclear Radiology Physician 2085N0904X 036158981 IL
Diagnostic Radiology Physician 2085R0202X 2019030490 MO

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044

Mailing address

12255 De Paul Dr Ste 737
Bridgeton, MO 63044-2530
Phone (314) 770-9393

Other practice location 1

230 N Broad St
Philadelphia, PA 19102-1121
Phone (215) 762-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190919002353 MO Practitioner - Diagnostic Radiology 2264762111 Reassigns benefits to 2 organizations
I20220805002726 IL Practitioner - Diagnostic Radiology 2264762111 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ernst Radiology Clinic IncGroup PAC ID 2264829639, 16 clinicians
Ernst Radiology Clinic, IncGroup PAC ID 2961488366, 20 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

12303 Depaul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036158981ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Hospital District CurrentSince Dec 23, 2025 Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 14, 2025 Accepting new patients
Specialt MRI, LLC Diagnostic Radiology CurrentSince Nov 15, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Ernst Radiology Clinic, Inc Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients
Ernst Radiology Clinic, Inc Diagnostic Radiology CurrentSince Nov 1, 2019 Accepting new patients
Washington County Hospital District CurrentSince Dec 23, 2025 Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

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

705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

12255 De Paul Dr
Ste 737
Bridgeton, MO 63044

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

Organizations & group practices 7

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 5

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1174933022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR STE 737",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442530",
            "telephone_number": "314-770-9393",
            "fax_number": "314-770-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-770-9393",
            "fax_number": "314-770-9997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "215-762-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHATMAN",
        "first_name": "CLELLAND",
        "middle_name": "JAMES-HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036158981",
            "primary": true
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IL",
            "license": "036158981",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019030490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.