SHAWNEE HEALTH CARE, CARBONDALE
NPI 1073745345
Clinic/Center - Federally Qualified Health Center (FQHC) in Carbondale, IL
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
Specialties & Licenses 6
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shawnee Health Care, Carbondale is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
52Medicare enrollment records show 52 clinicians reassign Medicare billing to Shawnee Health Care, Carbondale, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 35 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 52Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ILFrequently 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.
Is Shawnee Health Service And Development Corp enrolled in Medicare?
Yes. Shawnee Health Service And Development Corp is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shawnee Health Service And Development Corp?
According to the CMS Revalidation Reassignment List (October 2026 release), 52 clinicians in 8 Medicare specialties reassign their Medicare billing to Shawnee Health Service And Development Corp. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (15), Family Practice (8) and Certified Nurse Midwife (CNM) (7). Of these, 12 practice at this address and 35 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 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.
# Shawnee Health Care, Carbondale · NPI 1073745345
Federally Qualified Health Center (FQHC) organization in Carbondale, Illinois. Organization record, active in the CMS NPPES registry since August 20, 2009.
## Identity
- **NPI:** 1073745345 (Entity type: Organization)
- **Enumerated:** August 20, 2009
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Shawnee Health Service And Development Corp
- **Organization subpart:** Yes (part of Shawnee Health Service And Development Corp)
- **Authorized official:** Christina Carney, CEO
## Practice location
- **Address:** 400 S LEWIS LN, Carbondale, IL 62901-3547
- **Phone:** (618) 519-9900 · **Fax:** (618) 519-9961
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 52 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (15), Family Practice (8), Certified Nurse Midwife (CNM) (7); 12 practice at this address and 35 within 10 miles; [full list](https://npiprofile.com/npi/1073745345/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 17, 2024
- **Other identifiers:** Other CF3444 (IL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073745345) · Data from the CMS NPPES public registry.