Individual provider Active NPI

Gerald Wayne McClallen, D.O.

  • Emergency Medicine Physician
  • Murphysboro, IL
National Provider Identifier
1285686709
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-078422 Issued in IL
Practice address
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone
(618) 684-3156
Fax
(618) 529-0524
NPI assigned
May 16, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-078422 IL Primary

Addresses

Primary practice location

2 S Hospital Dr
Murphysboro, IL 62966-3333

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (800) 457-5200

Other practice location 1

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Other practice location 2

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address gmcclallen14217@sih.direct-ci.com
Direct Messaging Address gmcclallen14217@sih.direct-ci.com
Direct Messaging Address gmcclallen14217@sih.direct-ci.com

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000359 IL Practitioner - Emergency Medicine 2769477256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eldorado Emergency Group PCGroup PAC ID 3678955028, 14 clinicians

Practice addresses (Care Compare)

1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.25 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-078422ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eldorado Emergency Group PC Emergency Medicine CurrentSince Aug 15, 2022 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Sep 2, 2008 Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

1239 E Main St
Carbondale, IL 62901

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

200 Corporate Blvd
Lafayette, LA 70508

Interoperability endpoints

  • Direct secure messaging: gmcclallen14217@sih.direct-ci.com

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.

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1285686709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "800-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S HOSPITAL DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663333",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "fax_number": "618-351-4917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLALLEN",
        "first_name": "GERALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-09-29",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-078422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmcclallen14217@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmcclallen14217@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmcclallen14217@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murphysboro, IL

Sources for this page

Verify at the official NPI Registry.