Individual provider Active NPI

Michael G Guignon Jr., M.D.

  • Internal Medicine Physician
  • Shiloh, IL
National Provider Identifier
1942542931
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036140835 Issued in IL
Practice address
1414 Cross St Ste 230
Shiloh, IL 62269
Phone
(618) 607-1260
Fax
(618) 624-4856
NPI assigned
Mar 18, 2013
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 036140835 IL Primary
Hospitalist Physician 208M00000X 036140835 IL

Addresses

Primary practice location

1414 Cross St Ste 230
Shiloh, IL 62269

Mailing address

1414 Cross St Ste 230
Shiloh, IL 62269-2988
Phone (618) 607-1260

Other practice location 1

200 Health Care Dr
Greenville, IL 62246-1154
Phone (618) 664-1230

Other practice location 2

200 Health Care Dr
Greenville, IL 62246-1154
Phone (618) 664-1230

Other practice location 3

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 577-8762

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20160630001414 IL Practitioner - Internal MedicinePractitioner - Hospitalist 3779886791 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois SNF LLP Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Nov 1, 2019 Accepting new patients
Cep America - Illinois SNF, LLP Internal Medicine Current Accepting new patients
Cep America-Illinois Hospitalists Hospitalist CurrentSince Jul 1, 2016 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Aug 15, 2023 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine Current Accepting new patients
Cep America - Illinois SNF, LLP CurrentSince Oct 1, 2016 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

1414 Cross St
Ste 230
Shiloh, IL 62269
Phone (618) 607-1260

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

Organizations & group practices 8

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 9

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1942542931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 230",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692988",
            "telephone_number": "618-607-1260",
            "fax_number": "618-624-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 230",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-607-1260",
            "fax_number": "618-624-4856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Health Care Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "IL",
            "postal_code": "622461154",
            "country_code": "US",
            "telephone_number": "618-664-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Health Care Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "IL",
            "postal_code": "622461154",
            "country_code": "US",
            "telephone_number": "618-664-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1402 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-577-8762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUIGNON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036140835",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036140835",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1414 Cross St Ste 230",
            "city": "Shiloh",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

Verify at the official NPI Registry.