Individual provider Active NPI

Clare T Williams, MD

  • Family Medicine Physician
  • Murphysboro, IL
National Provider Identifier
1932146271
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036111461 Issued in IL
Practice address
7 S Hospital Dr
Murphysboro, IL 62966-3333
Phone
(618) 687-3418
Fax
(618) 687-1859
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036111461 IL Primary

Addresses

Primary practice location

7 S Hospital Dr
Murphysboro, IL 62966-3333

Mailing address

PO Box 577
Carterville, IL 62918-0577
Phone (618) 985-8221

Other identifiers 6

IdentifierTypeStateIssuer
CF3444OtherILMEDICARE RAILROAD GROUP #
P00215157OtherILMEDICARE RR #
10032052OtherILBC BS NUMBER
370966854002MedicaidIL
640701OtherILMEDICARE GROUP ID WPS FFS
036111461MedicaidIL

Other names 1

  • Clare T Fadden Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clare.fadden.1@14668.direct.athenahealth.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915001107 IL Practitioner - Family Practice 0547237752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shawnee Health Service and Development CorpGroup PAC ID 1658285671, 51 clinicians

Practice addresses (Care Compare)

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 942-2171

7 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 687-3418

Hospital & facility affiliations

  • Residential Home Health of Southern Illinois, LLC Home health agency, Marion, IL, CCN 147112
  • LHC-Illinois Home Health Care Home health agency, Marion, IL, CCN 147716
  • Hospice of Southern Illinois, Inc Hospice, Belleville, IL, CCN 141504
  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036111461ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Health Service and Development Corp Family Medicine Current Accepting new patients
Shawnee Health Service and Development Corp CurrentSince Aug 1, 2007 Accepting new patients
Shawnee Health Service and Development Corp Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Shawnee Health Service and Development Corp Family Medicine Past Accepting new patients

Locations

404 S Lewis Ln
Carbondale, IL 62901
Phone (618) 319-4076

109 California St
Carterville, IL 62918
Phone (618) 985-8221

1006 S Division St
Carterville, IL 62918
Phone (618) 985-4841

7 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 687-3418

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1932146271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-985-8221",
            "fax_number": "618-985-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S HOSPITAL DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663333",
            "telephone_number": "618-687-3418",
            "fax_number": "618-687-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CLARE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP #",
            "identifier": "CF3444",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR #",
            "identifier": "P00215157",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS NUMBER",
            "identifier": "10032052",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID WPS FFS",
            "identifier": "640701",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111461",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clare.fadden.1@14668.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CLARE",
            "last_name": "FADDEN",
            "middle_name": "T",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Murphysboro, IL

Sources for this page

Verify at the official NPI Registry.