NPIMap

Organization Active NPI

Generation Clinical Partners LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Glen Carbon, IL
National Provider Identifier
1366050007
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GENERATION CLINICAL PARTNERS LLC
Practice address
27 Auerbach PL
Glen Carbon, IL 62034-1596
Phone
(314) 925-0903
Fax
(314) 764-2279
NPI assigned
Jul 20, 2020
Last updated
Mar 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Mae Lin
Title
Office Manager
Phone
(314) 925-0903

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

27 Auerbach PL
Glen Carbon, IL 62034-1596

Mailing address

PO Box 14713
Belfast, ME 04915-4042
Phone (314) 925-0903

Other names 1

  • GCP Illinois, PLLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200908001358 IL Part B Supplier - Clinic/Group Practice 1557687803 Receives reassigned benefits from 8 practitioners
Practice locations: Belleville, IL; Glen Carbon, IL; Waterloo, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Generation Clinical Partners LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Arbor Ter
Fenton, MO 63026
Phone (618) 344-0071

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1366050007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14713",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154042",
            "telephone_number": "314-925-0903",
            "fax_number": "314-764-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 AUERBACH PL",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341596",
            "telephone_number": "314-925-0903",
            "fax_number": "314-764-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATION CLINICAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "MAE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-925-0903"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCP Illinois, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GCP Illinois, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.