Individual provider Active NPI

Alan John Wilson, M.D.

  • Family Medicine Physician
  • Herrin, IL
National Provider Identifier
1386774388
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD202418 Issued in LA
Practice address
201 S 14TH St
Herrin, IL 62948-3631
Phone
(618) 942-2171
Fax
(618) 351-4917
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2011008025 MO
Emergency Medicine Physician 207P00000X 036147913 IL
Family Medicine Physician 207Q00000X MD202418 LA Primary

Addresses

Primary practice location

201 S 14TH St
Herrin, IL 62948-3631

Mailing address

1239 E Main St
Carbondale, IL 62901-3175
Phone (618) 457-5200

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 2

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

Other practice location 3

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6350

Other practice location 4

1000 Ochsner Blvd
Covington, LA 70433-8107
Phone (985) 875-2340

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address awilson26614@sih.direct-ci.com
Direct Messaging Address awilson26614@sih.direct-ci.com
Direct Messaging Address awilson26614@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080917000667 LA Practitioner - Family PracticePractitioner - Emergency Medicine 8426125485 Reassigns benefits to 1 organization
I20190103001057 IL Practitioner - Emergency MedicinePractitioner - Family Practice 8426125485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1000 Ochsner Blvd
Covington, LA 70433-8107
Phone (985) 875-2828

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD202418LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Dec 1, 2024 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Dec 17, 2018 Accepting new patients
Camden Emergency Group LLC Emergency Medicine CurrentSince Aug 19, 2018 Accepting new patients
Ochsner Clinic LLC CurrentSince Dec 1, 2024 Accepting new patients
Emergency Medicine Specialist, Apmc Emergency Medicine Past Accepting new patients
Sulphur Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

1239 E Main St
Carbondale, IL 62901
Phone 6185490721 ext. 65799

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

1239 E Main St
Carbondale, IL 62901

405 W Jackson St
Carbondale, IL 62901

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

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

1000 Ochsner Blvd
Covington, LA 70433
Phone (985) 898-7051

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Interoperability endpoints

  • Direct secure messaging: awilson26614@sih.direct-ci.com
  • Direct secure messaging: awilson2315224@direct.ochsner.org

Organizations & group practices 7

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 5

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1386774388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013175",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 14TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483631",
            "telephone_number": "618-942-2171",
            "fax_number": "618-351-4917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655369210",
            "country_code": "US",
            "telephone_number": "417-533-6350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Ochsner Blvd",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704338107",
            "country_code": "US",
            "telephone_number": "985-875-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2011008025",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036147913",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD202418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awilson26614@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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awilson26614@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": "awilson26614@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"
        }
    ],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.