Individual provider Active NPI

Abigail Ryan Newman, PHD

  • Clinical Psychologist
  • Carbondale, IL
National Provider Identifier
1275245300
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008877 Issued in IL
Practice address
300 W Oak St
Carbondale, IL 62901-1400
Phone
(618) 536-6621
Fax
(618) 453-1102
NPI assigned
Dec 20, 2022
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.008877 IL Primary

Addresses

Primary practice location

300 W Oak St
Carbondale, IL 62901-1400

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

1728 Watt Hill Rd
Murphysboro, IL 62966-5353
Phone (815) 535-6317

Other names 1

  • Abigail Ryan Bilderback Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231205003688 IL Practitioner - Clinical Psychologist 0446609275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 W Oak St
Carbondale, IL 62901-1400
Phone (618) 536-6621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.008877ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince Oct 8, 2023 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 8, 2023 Accepting new patients

Locations

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1275245300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011400",
            "telephone_number": "618-536-6621",
            "fax_number": "618-453-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1728 Watt Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629665353",
            "country_code": "US",
            "telephone_number": "815-535-6317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "ABIGAIL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "BILDERBACK",
            "middle_name": "RYAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.