Gary D Carr, MD
Individual provider Active NPI Family Medicine Physician · Lawrenceville, IL
NPI 1245264183 · NPPES record last updated Sep 9, 2019
Key facts
- NPI
- 1245264183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036058645 (IL)
- Practice address
- 11020 State Route 250
Lawrenceville, IL 62439-3379 - Phone
- (618) 943-2609
- Fax
- (618) 943-6409
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 12
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of Lawrence Health Department
Lawrence County Memorial Hospital
Practice addresses (Care Compare)
2101 James St
Lawrenceville, IL 62439-2027
Phone (618) 943-3302
2200 State St
Lawrenceville, IL 62439-1852
Phone (618) 943-1000
2200 State St
Lawrenceville, IL 62439-1899
Hospital & facility affiliations
- Good Samaritan Home Care Services
- Good Samaritan Hospice
- Good Samaritan Hospice
- Lawrence County Memorial Hospital
- Good Samaritan Hospital
- Crawford Memorial Hospital
- University of Illinois Hospital and Clinics
- Wabash General Hospital 1
- The Haven of Bridgeport
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Lawrence County Memorial Hospital |
Hospital | Contracted Managing Employee (11.12%) Corporate Officer (11.12%) |
Oct 1, 2011 Oct 1, 2011 |
| The Haven of Bridgeport |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Mar 1, 2025 Mar 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031110000045 | IL | Practitioner - Family Practice | 4284547969 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036058645 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawrence County Memorial Hospital | Current |
Accepting new patients | |
| Lawrence County Memorial Hospital | Current |
Accepting new patients | |
| Lawrence County Memorial Hospital | Current |
Accepting new patients | |
| Associated Pathologists, LLC | Current | Accepting new patients |
Locations
2200 State St
Lawrenceville, IL 62439
Phone (618) 943-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036058645 | IL | Yes |
| Emergency Medicine Physician | 207P00000X | 036058645 | IL |
Addresses
Primary practice location
11020 State Route 250
Lawrenceville, IL 62439-3379
Mailing address
PO Box 516
Lawrenceville, IL 62439
Phone (618) 943-2609
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003230 | Other | IL | HEALTH ALLIANCE INS |
| 5132004 | Other | IL | BCBS |
| 1729885 | Other | FIRST HEALTH | |
| 376006178007 | Medicaid | IL | |
| 036058645 | Medicaid | IL | |
| 838915 | Other | UNITED HEALTHCARE | |
| 131890 | Other | IL | HEALTHLINK INS |
Other providers in Lawrenceville, IL
- Janie Brunson
- Brianna Bump
- Lacey Lynn Bunting
- Valerie Burns
- Andrew F. Caldwell
- CHI National Home Care, LLC
- William Scott Childress
- Chittick Optical Inc
- Tiffany Clapp
- Community Alternatives Illinois, Inc.
All providers in Lawrenceville, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.