Active NPI
Jonathan Lee McJunkin, MD
- Otolaryngology Physician
- Champaign, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036125895
- Practice address
- 3105 Fields South Dr
Champaign, IL 61822-3743 - Phone
- (217) 902-3277
- Fax
- (217) 383-4451
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 2011009453 | MO | |
| Otolaryngology Physician | 207Y00000X | 036125895 | IL | Primary |
Addresses
Primary practice location
3105 Fields South Dr
Champaign, IL 61822-3743
Mailing address
611 W Park St
Fapc
Urbana, IL 61801
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | IL | |
| 1336218643 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
207 Landmark Dr
Suite a
Normal, IL 61761-3195
Phone (309) 268-3212
2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222
3103 Fields S Dr
Champaign, IL 61822-3743
Phone (217) 902-2300
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Foundation Hospital
- Carle Bromenn Medical Center
- Saint Francis Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011009453 | MO | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle West Physician Group Inc | Current | Accepting new patients | |
| Carle Health Care Incorporated | Current | Accepting new patients | |
| Ozarks Medical Center | Otolaryngology | Past | Accepting new patients |
| Carle Health Care Incorporated | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352
3105 Fields South Dr
Champaign, IL 61822
Phone (217) 902-3277
207 Landmark Dr
Ste A
Normal, IL 61761
Phone (309) 268-3200
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- jmcjunkinmd319007@carlehiedirect.net
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Normal, IL
- NPI 1962424036
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1336218643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"address_2": "FAPC",
"city": "URBANA",
"state": "IL",
"postal_code": "61801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 FIELDS SOUTH DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618223743",
"telephone_number": "217-902-3277",
"fax_number": "217-383-4451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCJUNKIN",
"first_name": "JONATHAN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2021-02-26",
"certification_date": "2021-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MO",
"license": "2011009453",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036125895",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336218643",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.