John Gregg Fozard, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036053225 Issued in IL

Practice address

5383 State Route 154
Pinckneyville, IL 62274-3342

Phone

(618) 357-2131

Fax

(618) 357-3411

NPI assigned

Feb 7, 2006

Last updated

Jul 10, 2023By the provider in NPPES

Sex

Male

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 7

Electronic endpoints 1

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 Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinckneyville Community HospitalGroup PAC ID 8123921632, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pinckneyville Community Hospital Hospital, Pinckneyville, IL, CCN 141307
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Pinckneyville Nursing & Rehab Nursing home, Pinckneyville, IL, CCN 146175
• Coulterville Rehab & HCC Nursing home, Coulterville, IL, CCN 145993

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jfozard@direct.pvillehosp.org

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.

• Pinckneyville Community Hospital

  • Critical Access Hospital
  • Pinckneyville, IL
  • NPI 1689646523
  Medicare reassignment Care Compare group

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

• Coulterville Rehabilitation & Health Care Center, LLC

  dba Coulterville Rehabilitation & Health Care Center

  • Skilled Nursing Facility
  • Coulterville, IL
  • NPI 1457348435

  Nursing home

  Care Compare affiliation
• Pinckneyville Community Hospital

  • Critical Access Hospital
  • Pinckneyville, IL
  • NPI 1689646523
  Care Compare affiliation
• Pinckneyville Nursing & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Pinckneyville, IL
  • NPI 1013456490

  Nursing home

  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1689646127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "address_2": "PO BOX 437",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2131",
            "fax_number": "618-357-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2131",
            "fax_number": "618-357-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOZARD",
        "first_name": "JOHN",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036053225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FMC GROUP PROVIDER #",
            "identifier": "7320380",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080174912",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053225",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE ID",
            "identifier": "2288028",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PHYS PROVIDER #",
            "identifier": "0027340080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE ID",
            "identifier": "034761",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER ID",
            "identifier": "122435",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfozard@direct.pvillehosp.org",
            "affiliation": "N",
            "endpointDescription": "Family Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Clinical Summary, TOC, CCD",
            "address_1": "5383 State Route 154",
            "city": "Pinckneyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622743342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Family Dental Center of Pinckneyville LLC
• Gerald Lee Farris
• Foot & Ankle Center, LLC
• Andrew James Forbes, M.D., PH.D.
• Elizabeth Forsberg
• Amanda Frassato, FNP
• Dawn M Galbraith, CLC
• Joseph Frank Grasso, O.D.
• Laura K. Harrawood, PH.D.
• Judith Lynn Hastings, RN

• Family Medicine Physician in Pinckneyville, IL
• Providers in Pinckneyville, 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 Jul 10, 2023; 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.