NPIMap

Individual provider Active NPI

Tamara Collard, P.A.

  • Physician Assistant
  • Du Quoin, IL
National Provider Identifier
1508960915
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001366 Issued in IL
Practice address
1564 S Washington St
Du Quoin, IL 62832-3849
Phone
(618) 542-8702
Fax
(618) 542-8792
NPI assigned
Sep 8, 2006
Last updated
Jan 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001366 IL Primary

Addresses

Primary practice location

1564 S Washington St
Du Quoin, IL 62832-3849

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401

Other names 1

  • Tamara Edwards Former name

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
I20040617000027 IL Practitioner - Physician Assistant 8123002052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1564 S Washington St
Du Quoin, IL 62832-3849
Phone (618) 542-8702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-001366ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Greater Area Rural Health Planning Corporation CurrentSince Apr 18, 2016 Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Physician Assistant CurrentSince Apr 18, 2016 Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Physician Assistant Past Accepting new patients
Christopher Greater Area Rural Health Planning Corporation Past Accepting new patients
Southern Illinois Medical Care Associates LLC Past Accepting new patients

Locations

4241 Highway 14 W
Christopher, IL 62822
Phone (618) 724-1684

4241 State Highway 14
Christopher, IL 62822
Phone (618) 724-2136

1564 S Washington St
Du Quoin, IL 62832
Phone (618) 542-8702

14410 Route 37
Johnston City, IL 62951
Phone (618) 937-6409

2920 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (618) 244-6544

6294 State Highway 154
Sesser, IL 62884
Phone (618) 625-6679

Interoperability endpoints

  • Direct secure messaging: tamara.collard@crhpc.eclinicaldirectplus.com

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 7

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1508960915",
    "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": "1564 S WASHINGTON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323849",
            "telephone_number": "618-542-8702",
            "fax_number": "618-542-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLARD",
        "first_name": "TAMARA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "EDWARDS",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Du Quoin, IL

Sources for this page

Verify at the official NPI Registry.