Individual provider Active NPI

Meredith Grace Lukens, PA-C

  • Physician Assistant
  • Carterville, IL
National Provider Identifier
1588183487
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006425 Issued in IL
Practice address
1400 Pin Oak Dr
Carterville, IL 62918-1600
Phone
(618) 985-3333
Fax
(618) 985-1318
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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 085.006425 IL Primary

Addresses

Primary practice location

1400 Pin Oak Dr
Carterville, IL 62918-1600

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other names 1

  • Meredith Worrall Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlukens86157@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171115000212 IL Practitioner - Physician Assistant 2365708930 Reassigns benefits to 1 organization
I20200318000661 IA Practitioner - Physician Assistant 2365708930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Pin Oak Dr
Carterville, IL 62918-1600
Phone (618) 985-3333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.006425ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission CurrentSince Feb 3, 2020 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

800 11th St
Charles City, IA 50616
Phone (641) 228-6830

1501 S Main St
Ste 6
Charles City, IA 50616
Phone (641) 228-5151

Interoperability endpoints

  • Direct secure messaging: meredith.lukens@crhpc.eclinicaldirectplus.com
  • Direct secure messaging: mlukens21973@sih.direct-ci.com

Organizations & group practices 4

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1588183487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PIN OAK DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181600",
            "telephone_number": "618-985-3333",
            "fax_number": "618-985-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKENS",
        "first_name": "MEREDITH",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlukens86157@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1400 Pin Oak Dr",
            "city": "Carterville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629181600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "WORRALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carterville, IL

Sources for this page

Verify at the official NPI Registry.