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SHAWNEE HEALTH CARE, CARBONDALE
NPI 1073745345
Clinic/Center - Federally Qualified Health Center (FQHC) in Carbondale, IL

Active since August 20, 2009CLIA 14D2000480 · Waiver
400 S LEWIS LN, CARBONDALE, IL 62901(618) 519-9900(618) 519-9961 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 17, 2024, Apr 4, 2024, Dec 23, 2016 and 1 more (4 updates tracked since 2016).

About Shawnee Health Care, Carbondale NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWNEE HEALTH CARE, CARBONDALE (NPI 1073745345) is a healthcare organization registered as a federally qualified health center (fqhc) in Carbondale, Illinois and active in the NPI registry since August 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Christina Carney, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073745345
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Location Address400 S LEWIS LNCarbondale, IL 62901-3547
Mailing Address109 California St, Po Box 577Carterville, IL 62918-1923 · (618) 985-8221 · Fax (618) 985-6860
Phone(618) 519-9900
Fax(618) 519-9961
Organization SubpartYes
Authorized OfficialChristina CarneyCeo · (618) 956-9521
Enumeration DateAugust 20, 2009
Last NPPES UpdateJuly 17, 20244 updates tracked since enumeration
NPPES CertifiedJuly 17, 2024
✔ NPI 1073745345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedDentist · General PracticeTaxonomy 1223G0001X
Also ListedDental HygienistTaxonomy 124Q00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
400 S LEWIS LN, Carbondale, IL 62901
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Other Names 1

Doing Business AsShawnee Health Care, Carbondale

Other Identifiers 1

OtherCF3444IL · Medicare Rr

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2000480

Shawnee Health Care Carbondale · Carbondale, IL
Active · expires Aug 31, 2027
CLIA Number14D2000480
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorClare Williams M D
Laboratory Phone(618) 519-9900
Laboratory LocationShawnee Health Care Carbondale400 South Lewis Lane, Carbondale, IL 62901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

POORVA TALAPATRA M.ED., LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
MRS. SARA HOYLE PA-C
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
LABORATORY CORPORATION OF AMERICA
Clinical Medical Laboratory
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 351-0016
MCKENZIE BONIFIELD
Nurse Practitioner (Family)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200
TIFFANY D ALLEN LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200
MICHAEL ROHLING MS, LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
MR. ETHAN WESHINSKEY PA-C
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200
DR. RENEE BARNES FEATHER MD
Family Medicine
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawnee Health Service And Development Corp's NPI number?

The NPI number for Shawnee Health Service And Development Corp is 1073745345. It was assigned to this organization in the NPPES registry on August 20, 2009. The provider is doing business as Shawnee Health Care, Carbondale.

Where is Shawnee Health Service And Development Corp located?

Shawnee Health Service And Development Corp is located at 400 S Lewis Ln, Carbondale, IL 62901. The listed phone number is (618) 519-9900.

What is Shawnee Health Service And Development Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Shawnee Health Service And Development Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2000480) is associated with this NPI, valid through August 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Shawnee Health Service And Development Corp accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Shawnee Health Service And Development Corp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shawnee Health Service And Development Corp was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.