Individual provider Active NPI

Ross Cameron Pepper, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1639639297
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.166098 Issued in IL
Practice address
3665 N Broadway St
Chicago, IL 60613-4567
Phone
(773) 496-4433
Fax
(386) 515-8239
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.166098 IL Primary

Addresses

Primary practice location

3665 N Broadway St
Chicago, IL 60613-4567

Mailing address

3665 N Broadway St
Chicago, IL 60613-4567

Other practice location 1

929 W Belmont Ave
Chicago, IL 60657-4408
Phone (312) 530-0323

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240408000288 IL Practitioner - Psychiatry 4284964040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

333 N Michigan Ave
Suite 1400
Chicago, IL 60601-4011
Phone (312) 815-9660

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC CurrentSince Mar 18, 2024 Accepting new patients

Locations

929 W Belmont Ave
Chicago, IL 60657
Phone (312) 530-0323

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

3665 N Broadway St
Chicago, IL 60613
Phone (773) 496-4433

Interoperability endpoints

  • Direct secure messaging: rpepper18666@uihealth.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1639639297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567",
            "telephone_number": "773-496-4433",
            "fax_number": "386-515-8239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606574408",
            "country_code": "US",
            "telephone_number": "312-530-0323",
            "fax_number": "386-515-8239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "ROSS",
        "middle_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.166098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.