Pamela J Clarida, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209021732 Issued in IL

Practice address

2808 E Outer Dr
Marion, IL 62959-5207

Phone

(618) 993-3817

Fax

(618) 993-3908

NPI assigned

Sep 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
• Herrin Hospital Hospital, Herrin, IL, CCN 140011

Merit-based Incentive Payment System (MIPS)

Final score

82 of 100Reported as group

Quality

55.9

Promoting interoperability

100

Improvement activities

40

Cost

72.01

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pclarida22804@sih.direct-ci.com

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.

• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment Care Compare group NPD

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

• Harrisburg Medical Center Inc

  • General Acute Care Hospital
  • Harrisburg, IL
  • NPI 1073580130
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1790391977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E ILLINOIS ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593711",
            "telephone_number": "618-972-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 E OUTER DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595207",
            "telephone_number": "618-993-3817",
            "fax_number": "618-993-3908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Illinois St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629593711",
            "country_code": "US",
            "telephone_number": "618-972-9326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 S Commercial St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462640",
            "country_code": "US",
            "telephone_number": "618-993-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARIDA",
        "first_name": "PAMELA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020024176",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021732",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209021732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pclarida22804@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2808 E Outer Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Marion, IL
• Providers in Marion, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.