NPIMap

Individual provider Active NPI

Charelle Octavia Smith, MD

  • Family Medicine Physician
  • Du Quoin, IL
National Provider Identifier
1285128504
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.153658 Issued in IL
Practice address
1564 S Washington St
Du Quoin, IL 62832-3849
Phone
(618) 542-8702
Fax
(618) 542-8792
NPI assigned
Jun 20, 2018
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.153658 IL Primary

Addresses

Primary practice location

1564 S Washington St
Du Quoin, IL 62832-3849

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401

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
I20201113000423 IL Practitioner - Family Practice 6305194283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1564 S Washington St
Du Quoin, IL 62832-3849
Phone (618) 542-8702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.153658ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Greater Area Rural Health Planning Corporation CurrentSince Aug 30, 2021 Accepting new patients
Christopher Greater Area Rural Health Planning Corp Family Medicine CurrentSince Aug 30, 2021 Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Family Medicine Current Accepting new patients
Granite City Hospitalist Services LLC CurrentSince Dec 1, 2021 Accepting new patients
Integritas Emergency Physician Services, LLC CurrentSince Nov 1, 2020 Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Family Medicine Past Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Family Medicine Past Accepting new patients

Locations

206 E Church St
#B
Benton, IL 62812
Phone (618) 435-9888

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

4241 Highway 14 W
Christopher, IL 62822
Phone (618) 724-1684

4241 State Highway 14
Christopher, IL 62822
Phone (618) 724-2136

1564 S Washington St
Du Quoin, IL 62832
Phone (618) 542-8702

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

3303 Logan Dr
Herrin, IL 62948
Phone (618) 833-4471

2920 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (618) 244-6544

4117 S Water Tower Pl
Ste D
Mount Vernon, IL 62864
Phone (618) 242-4848

6294 State Highway 154
Sesser, IL 62884
Phone (618) 625-6679

Interoperability endpoints

  • Direct secure messaging: charelle.smith@crhpc.eclinicaldirectplus.com
  • Direct secure messaging: csmith10@yourcarecommunity.org

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 6

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1285128504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2401",
            "fax_number": "618-453-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1564 S WASHINGTON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323849",
            "telephone_number": "618-542-8702",
            "fax_number": "618-542-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARELLE",
        "middle_name": "OCTAVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.153658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Quoin, IL

Sources for this page

Verify at the official NPI Registry.