NPIMap

Individual provider Active NPI

Jason G. Chamberlin, DO

  • Internal Medicine Physician
  • Farmington, IL
National Provider Identifier
1831207349
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036101084 Issued in IL
Practice address
601 E Fort St
Farmington, IL 61531-0380
Phone
(309) 245-2406
Fax
(309) 649-6880
NPI assigned
Aug 25, 2006
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036101084 IL Primary
Pediatrics Physician 208000000X 036101084 IL

Addresses

Primary practice location

601 E Fort St
Farmington, IL 61531-0380

Mailing address

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

Other identifiers 10

IdentifierTypeStateIssuer
02922981OtherILBCBS
CG5172OtherILRR MEDICARE GROUP#
0062839OtherILUMWA
101084OtherILOSF HEALTHPLANS
1942315197OtherILNPI CLINIC NUMBER
461760OtherILHEALTH LINK
IL0139OtherILJOHN DEERE
036101084MedicaidIL
069684OtherILHEALTH ALLIANCE
200397OtherILBLACK LUNG

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.chamberlin@gmgil.eclinicaldirectplus.com Health Information Exchange (HIE) Graham Hospital Association

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
I20040923000678 IL Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Emergency Medicine 3072581313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

601 E Fort St
Farmington, IL 61531-1338
Phone (309) 647-0201

61 E Side SQ
Canton, IL 61520-2603
Phone (309) 649-1572

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
62.57
Promoting interoperability
100
Improvement activities
40
Cost
77.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036101084ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association Internal Medicine CurrentSince Jul 1, 2001 Accepting new patients
Graham Hospital Association CurrentSince Jul 1, 2001 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Major Hospital Past Accepting new patients
Graham Services Corporation Internal Medicine Past Accepting new patients

Locations

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

601 E Fort St
Farmington, IL 61531
Phone (309) 245-2406

Interoperability endpoints

  • Direct secure messaging: jason.chamberlin@gmgil.eclinicaldirectplus.com

Organizations & group practices 6

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 11

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1831207349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-647-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E FORT ST",
            "city": "FARMINGTON",
            "state": "IL",
            "postal_code": "615310380",
            "telephone_number": "309-245-2406",
            "fax_number": "309-649-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLIN",
        "first_name": "JASON",
        "middle_name": "G.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036101084",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036101084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02922981",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP#",
            "identifier": "CG5172",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0062839",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSF HEALTHPLANS",
            "identifier": "101084",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CLINIC NUMBER",
            "identifier": "1942315197",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "461760",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0139",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101084",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "069684",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "200397",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.chamberlin@gmgil.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Graham Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "601 E Fort St",
            "city": "Farmington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615310380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, IL

Sources for this page

Verify at the official NPI Registry.