NPIMap

Individual provider Active NPI

Clayton T Ford, MD

  • Family Medicine Physician
  • Harrisburg, IL
National Provider Identifier
1689960650
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036134206 Issued in IL
Practice address
716 S Commercial St
Harrisburg, IL 62946-2346
Phone
(618) 273-3361
NPI assigned
Jun 28, 2011
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11016194A IN
Family Medicine Physician 207Q00000X 036134206 IL Primary

Addresses

Primary practice location

716 S Commercial St
Harrisburg, IL 62946-2346

Mailing address

1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361

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
I20140625001397 IL Practitioner - Family Practice 8224283452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Illinois Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Small St
Harrisburg, IL 62946-3319
Phone (618) 294-8264

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036134206ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ferrell Hospital Community Foundation Family Medicine CurrentSince Oct 17, 2022 Accepting new patients
Ferrell Hospital Community Foundation Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Feb 1, 2022 Accepting new patients
Ferrell Hospital Community Foundation Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361

1306 Maple St
Eldorado, IL 62930
Phone (618) 273-2360

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625

250 Small St
Harrisburg, IL 62946
Phone (618) 252-4000

716 S Commercial St
Harrisburg, IL 62946
Phone (618) 273-3361

901 S Commercial St
Harrisburg, IL 62946
Phone (618) 252-0411

Interoperability endpoints

  • Direct secure messaging: cford22222@sih.direct-ci.com
  • Direct secure messaging: cford50511@direct.deaconess.com
  • Direct secure messaging: clayton.ford@hmcclinic.directbygreenway.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1689960650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S COMMERCIAL ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462346",
            "telephone_number": "618-273-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "CLAYTON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11016194A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036134206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

Verify at the official NPI Registry.