Individual provider Active NPI

Paris McClendon, PA-C

  • Medical Physician Assistant
  • Decatur, IL
National Provider Identifier
1790362937
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
320 E Central Ave
Decatur, IL 62521-4665
Phone
(217) 877-9117
NPI assigned
Mar 25, 2021
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X IL Primary

Addresses

Primary practice location

320 E Central Ave
Decatur, IL 62521-4665

Mailing address

1757 S Country Club Rd Apt 205
Decatur, IL 62521-4497
Phone (601) 434-6941

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722000754 IL Practitioner - Physician Assistant 2668875022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

1504 S Albany Ave
Chicago, IL 60623-2209
Phone (312) 666-3494

1701 W Superior St
Chicago, IL 60622-5646
Phone (312) 666-3494

2418 W Division St
Chicago, IL 60622-2940
Phone (312) 666-3494

2750 W N Ave
Chicago, IL 60647-5247
Phone (312) 666-3494

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Improvement Center CurrentSince Apr 13, 2021 Accepting new patients
Erie Family Health Center Inc CurrentSince May 20, 2024 Accepting new patients
Erie Family Health Center, Inc Past Accepting new patients

Locations

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-2056

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

Interoperability endpoints

  • Direct secure messaging: paris.mcclendon.p31@direct.fhn-fqhc.nextgenshare.com
  • Direct secure messaging: pmcclendon708932@direct.ochin.org

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 1

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1790362937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 S COUNTRY CLUB RD APT 205",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214497",
            "telephone_number": "601-434-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E CENTRAL AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214665",
            "telephone_number": "217-877-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "PARIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.