NPIMap

Individual provider Active NPI

Gary D Carr, MD

  • Family Medicine Physician
  • Lawrenceville, IL
National Provider Identifier
1245264183
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036058645 Issued in IL
Practice address
11020 State Route 250
Lawrenceville, IL 62439-3379
Phone
(618) 943-2609
Fax
(618) 943-6409
NPI assigned
Jul 10, 2006
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036058645 IL
Family Medicine Physician 207Q00000X 036058645 IL Primary

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 7

IdentifierTypeStateIssuer
131890OtherILHEALTHLINK INS
003230OtherILHEALTH ALLIANCE INS
838915OtherUNITED HEALTHCARE
036058645MedicaidIL
376006178007MedicaidIL
5132004OtherILBCBS
1729885OtherFIRST HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031110000045 IL Practitioner - Family Practice 4284547969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 DepartmentGroup PAC ID 9830093723, shared by 3 NPIs, 3 clinicians
Lawrence County Memorial HospitalGroup PAC ID 7517144249, shared by 4 NPIs, 33 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036058645ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Pathologists, LLC Current Accepting new patients
Lawrence County Memorial Hospital CurrentSince Jul 1, 2011 Accepting new patients
Lawrence County Memorial Hospital CurrentSince Jul 1, 2011 Accepting new patients
Lawrence County Memorial Hospital CurrentSince Dec 22, 2025 Accepting new patients

Locations

2200 State St
Lawrenceville, IL 62439
Phone (618) 943-1000

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lawrence County Memorial HospitalLawrenceville, IL, CCN 14Z344 Hospital Contracted Managing Employee (11.12%)
Corporate Officer (11.12%)		 Oct 1, 2011
Oct 1, 2011
The Haven of BridgeportBridgeport, IL, CCN 145918 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 12

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1245264183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "62439",
            "telephone_number": "618-943-2609",
            "fax_number": "618-943-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 STATE ROUTE 250",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624393379",
            "telephone_number": "618-943-2609",
            "fax_number": "618-943-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "GARY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036058645",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036058645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK INS",
            "identifier": "131890",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE INS",
            "identifier": "003230",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "838915",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058645",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376006178007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5132004",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1729885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, IL

Sources for this page

Verify at the official NPI Registry.