Gretchen B Mason, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0850003442 Issued in IL

Practice address

510 Lincoln Dr
Herrin, IL 62948-6334

Phone

(618) 997-6800

Fax

(618) 998-9124

NPI assigned

Oct 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gretchen B Childers Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Orthopedic Associates SCGroup PAC ID 8921095514, 29 clinicians

Deaconess Illinois Specialty Clinic, Inc.Group PAC ID 9830562016, 145 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Herrin Hospital Hospital, Herrin, IL, CCN 140011

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmason@yourcarecommunity.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: gmason419463@direct.deaconess.com

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.

• Deaconess Illinois Specialty Clinic, Inc.

  • Surgery Physician
  • Marion, IL
  • NPI 1972210235

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Southern Orthopedic Associates SC

  • Orthopaedic Surgery Physician
  • Herrin, IL
  • NPI 1396792412

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Advanced Surgical Technology, LLC

  • Rural Health Clinic/Center
  • Carlyle, IL
  • NPI 1831876838
  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Hospitalist Physician
  • Anna, IL
  • NPI 1225858251

  Physician Assistant

  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Hospitalist Physician
  • Red Bud, IL
  • NPI 1780369132
  NPD
• Deaconess Illinois Clinic, Inc

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1245956523
  NPD (past)

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

• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1245229111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "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 DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "GRETCHEN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "0850003442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRETCHEN",
            "last_name": "CHILDERS",
            "middle_name": "B",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David A. Mann, M.D.
• Susan Mann, AUD CCCA
• Marion Eye Centers LTD.
• Daniel Leslie Marsh, LCPC
• Rachel Martineau, NP
• Cheryl Lynn Matic, COTA/L
• David E Matthews, LCSW
• Mack E McCain, M.D.
• Rebecca McCollum
• Dena L McCormick, PA-C

• Physician Assistant in Herrin, IL
• Providers in Herrin, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.