Active NPI
Tracy L Thompson, PA-C
- Physician Assistant
- Benton, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085010786
- Practice address
- 206 E Church St Ste B
Benton, IL 62812-2239 - Phone
- (618) 435-9888
- NPI assigned
- Mar 20, 2024
- Last updated
- Apr 15, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085010786 | IL | Primary |
Addresses
Primary practice location
206 E Church St Ste B
Benton, IL 62812-2239
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401
Other practice location 1
4230 Lincolnshire Dr Ste A
Mount Vernon, IL 62864-2189
Phone (618) 315-6466
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
206 E Church St
Suite B
Benton, IL 62812-2239
Phone (618) 435-9888
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085010786 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Illinois Specialty Clinic, Inc. | Current | Accepting new patients | |
| Deaconess Illinois Specialty Clinic, Inc. | Physician Assistant | Current | Accepting new patients |
| Advanced Urologic Surgeons PC | Past | Accepting new patients | |
| Deaconess Illinois Clinic, Inc | Past | Accepting new patients | |
| Heartland Occupational Medicine Physicians of Illinois S C | Past | Accepting new patients |
Locations
303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050
2700 W Deyoung St
Marion, IL 62959
Phone (618) 969-8633
3111 Broadway St
Mount Vernon, IL 62864
Phone (618) 241-0300
818 E Broadway St
Sparta, IL 62286
Phone (618) 443-2177
509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939
909 W Main St
West Frankfort, IL 62896
Phone (618) 372-6040
Interoperability endpoints
- ahujabariatricandbeyond.tracythompson@153356.advancedmd-direct.com
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Christopher, IL
- NPI 1639159213
-
dba Deaconess IL Specialty 4117 Water Tower
- Family Medicine Physician
- Mount Vernon, IL
- NPI 1003523374
-
dba Deaconess Care Group Illinois Union County
- Hospitalist Physician
- Anna, IL
- NPI 1225858251
Physician Assistant
-
- Specialist
- Mount Vernon, IL
- NPI 1093901340
-
dba Deaconess Illinois Clinic
- Family Medicine Physician
- Mount Vernon, IL
- NPI 1245956523
-
dba UltiMed Plus
- Family Medicine Physician
- Mount Vernon, IL
- NPI 1720057730
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Crossroads Community Hospital
- General Acute Care Hospital
- Mount Vernon, IL
- NPI 1124745807
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1407616303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 155",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "628220155",
"telephone_number": "618-724-2401",
"fax_number": "618-724-4628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 E CHURCH ST STE B",
"city": "BENTON",
"state": "IL",
"postal_code": "628122239",
"telephone_number": "618-435-9888"
}
],
"practiceLocations": [
{
"address_1": "4230 Lincolnshire Dr Ste A",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "IL",
"postal_code": "628642189",
"country_code": "US",
"telephone_number": "618-315-6466",
"fax_number": "866-755-6173",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "TRACY",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-20",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085010786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Benton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.