Individual provider Active NPI

Ruth Amber Wilkinson, PA-C

  • Medical Physician Assistant
  • Mount Carmel, IL
National Provider Identifier
1376910133
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.005601 Issued in IL
Practice address
1430 College Dr
Suite a
Mount Carmel, IL 62863-2649
Phone
(618) 262-5113
Fax
(618) 263-3195
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.005601 IL Primary

Addresses

Primary practice location

1430 College Dr
Suite a
Mount Carmel, IL 62863-2649

Mailing address

1430 College Dr
Suite a
Mount Carmel, IL 62863-2649
Phone (618) 262-5113

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014000597 IL Practitioner - Physician Assistant 3870802887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wabash General Hospital DistrictGroup PAC ID 8022908185, 77 clinicians

Practice addresses (Care Compare)

1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.005601ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wabash General Hospital District CurrentSince Oct 1, 2017 Accepting new patients
Wabash General Hospital District CurrentSince Oct 1, 2017 Accepting new patients

Locations

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

1430 College Dr
#A
Mount Carmel, IL 62863
Phone (618) 262-5113

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1376910133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLLEGE DR",
            "address_2": "SUITE A",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632649",
            "telephone_number": "618-262-5113",
            "fax_number": "618-263-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 COLLEGE DR",
            "address_2": "SUITE A",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632649",
            "telephone_number": "618-262-5113",
            "fax_number": "618-263-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "RUTH",
        "middle_name": "AMBER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.005601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, IL

Sources for this page

Verify at the official NPI Registry.