Individual provider Active NPI

Rashad Clifton Wilkerson, D.O.

  • Gastroenterology Physician
  • Urbana, IL
National Provider Identifier
1821152067
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036169528 Issued in IL
Practice address
611 W Park
Fapc
Urbana, IL 61802
Phone
(217) 902-6954
Fax
(217) 902-7711
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036169528 IL Primary
Gastroenterology Physician 207RG0100X 18229 WI
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 0102201636 VA

Addresses

Primary practice location

611 W Park
Fapc
Urbana, IL 61802

Mailing address

611 W Park
Fapc
Urbana, IL 61802
Phone (217) 902-6954

Other practice location 1

8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone (301) 295-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160815002143 VA Practitioner - Gastroenterology 4688812688
I20240619000033 IL Practitioner - Gastroenterology 4688812688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy50
Upper gastrointestinal (GI) endoscopy for acid reflux104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Gibson Community Hospital Association Single Specialty Past Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: rashad.wilkerson.2@14718.direct.athenahealth.com
  • Direct secure messaging: rwilkersonmd414534@carlehiedirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1821152067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61802",
            "telephone_number": "217-902-6954",
            "fax_number": "217-902-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61802",
            "telephone_number": "217-902-6954",
            "fax_number": "217-902-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "301-295-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "RASHAD",
        "middle_name": "CLIFTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036169528",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "18229",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0102201636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.