NPIMap

Organization Active NPI

Lincoln Surgical Associates, LTD.

  • Surgery Physician
  • Shiloh, IL
National Provider Identifier
1861706814
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LINCOLN SURGICAL ASSOCIATES, LTD.
Practice address
1414 Cross St Ste 330
Shiloh, IL 62269
Phone
(618) 277-7400
Fax
(618) 277-7422
NPI assigned
Aug 2, 2010
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
James John Clanahan, M.D.
Title
President
Phone
(618) 277-7400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1414 Cross St Ste 330
Shiloh, IL 62269

Mailing address

1414 Cross St Ste 330
Shiloh, IL 62269-2988
Phone (618) 277-7400

Other practice location 1

251 Marketplace Dr Ste 1
Freeburg, IL 62243-4082
Phone (618) 539-0067

Other practice location 2

739 N Jefferson St Ste 200
Mascoutah, IL 62258-1447
Phone (618) 566-8810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110221000715 IL Part B Supplier - Clinic/Group Practice 9335320597 Receives reassigned benefits from 26 practitioners
Practice locations: Shiloh, IL; Mascoutah, IL; Freeburg, IL

National Provider Directory

National Provider Directory

Locations

4550 Memorial Dr
Ste 100
Belleville, IL 62226
Phone (618) 234-3173

251 Marketplace Dr
Ste 100
Freeburg, IL 62243
Phone (618) 539-0067

739 N Jefferson St
#200
Mascoutah, IL 62258
Phone (618) 539-0067

3 Saint Elizabeth Blvd
Ste 3400
O Fallon, IL 62269
Phone (618) 234-3172

1414 Cross St
Ste 330
Shiloh, IL 62269
Phone (618) 228-8610

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1861706814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 330",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692988",
            "telephone_number": "618-277-7400",
            "fax_number": "618-277-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 330",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-277-7400",
            "fax_number": "618-277-7422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 Marketplace Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Freeburg",
            "state": "IL",
            "postal_code": "622434082",
            "country_code": "US",
            "telephone_number": "618-539-0067",
            "fax_number": "618-539-0288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "739 N Jefferson St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mascoutah",
            "state": "IL",
            "postal_code": "622581447",
            "country_code": "US",
            "telephone_number": "618-566-8810",
            "fax_number": "618-566-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LINCOLN SURGICAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "CLANAHAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-277-7400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.