Shawn M Fry, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-108501 Issued in IL

Practice address

610 N. Westgate
Jacksonville, IL 62650

Phone

(217) 245-9931

NPI assigned

Oct 5, 2006

Last updated

Dec 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shawn M Hembrough Other name

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

Specialty

Family PracticeAlso: Hospice/Palliative Care

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Anthony's Health Center Hospital, Alton, IL, CCN 140052
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Osf Healthcare System

  • Certified Registered Nurse Anesthetist
  • Monmouth, IL
  • NPI 1811016124
  Medicare reassignment NPD
• Osf Healthcare System

  • Rural Health Clinic/Center
  • Kewanee, IL
  • NPI 1427475177
  NPD
• Osf Healthcare System

  dba OSF Saint Katharine Medical Center

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Osf Healthcare System

  dba Osf Saint Anthony's Health Center

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1710396932
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1659467793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N. WESTGATE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-245-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "SHAWN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-108501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108501",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "HEMBROUGH",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Roddy Frankel, MD
• Freeman Counseling & Play Therapy, PLLC
• Sarah Freeman, LCSW, LSCSW, RPT
• Jessica Fricke, M.A.CCC-SLP
• Joni L Frisch, DTV
• Drake Gashkoff, M.D.
• Gateway Foundation, Inc.
• Gateway Foundation, Inc.
• Gateway Foundation, Inc. - BHC (Alpharus Health)
• Gateway Professional Services, PC

• Family Medicine Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.

Verify at the official NPI Registry.