NPIMap

Individual provider Active NPI

Clinton Jay Mohr, M.D.

  • Internal Medicine Physician
  • Marion, IL
National Provider Identifier
1356427736
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036119956 Issued in IL
Practice address
1008 W Cherry St
Ste D
Marion, IL 62959-1998
Phone
(618) 997-2396
Fax
(618) 997-1901
NPI assigned
Oct 28, 2006
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006030252 MO
Emergency Medicine Physician 207P00000X 036.119956 IL
Internal Medicine Physician 207R00000X 036119956 IL Primary

Addresses

Primary practice location

1008 W Cherry St
Ste D
Marion, IL 62959-1998

Mailing address

1008 W Cherry St
Ste D
Marion, IL 62959-1998
Phone (618) 997-2396

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
I20080408000672 IL Practitioner - Internal Medicine 6709963291 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statera Health Care LLCGroup PAC ID 0244565729, 41 clinicians
Eldorado Emergency Group PCGroup PAC ID 3678955028, 14 clinicians
Integritas Emergency Physician Services LLCGroup PAC ID 7113167446, 41 clinicians

Practice addresses (Care Compare)

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

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

8 Doctors Pkwy
Mount Vernon, IL 62864-6224
Phone (618) 244-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.119956ILMDEmergency Medicine Physician
036119956ILMDInternal Medicine Physician
2006030252MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Statera Health Care, LLC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Integritas Emergency Physician Services, LLC Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients
Eye Microsurgery, LTD. PastSince Jun 1, 2023 Accepting new patients

Locations

517 N Main St
Anna, IL 62906
Phone (618) 833-2295

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

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

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

3333 W Deyoung St
Ste 205
Marion, IL 62959
Phone (618) 998-1161

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1356427736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 W CHERRY ST",
            "address_2": "STE D",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591998",
            "telephone_number": "618-997-2396",
            "fax_number": "618-997-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 W CHERRY ST",
            "address_2": "STE D",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591998",
            "telephone_number": "618-997-2396",
            "fax_number": "618-997-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "CLINTON",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006030252",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.119956",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036119956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.