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MR. HOLLIS JOHNSON CLARK JR. P.A.-C.
NPI 1154659894
Physician Assistant in Herrin, IL

Active since November 18, 2009PECOS Enrolled
90.37/100
CMS Quality Rating
510 LINCOLN DR, HERRIN, IL 62948(618) 997-6800(618) 997-1187 Get Directions Write a Review

NPPES record last updated: February 23, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Hollis Johnson Clark Jr. P.a.-c. NPPES

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

MR. HOLLIS JOHNSON CLARK JR. P.A.-C. (NPI 1154659894) is an individual physician assistant in Herrin, Illinois, licensed in Kentucky (TC051) and active in the NPI registry since November 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154659894
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. HOLLIS JOHNSON CLARK JR.Credential: P.A.-C.
Location Address510 LINCOLN DRHerrin, IL 62948-6334
Mailing Address4787 Alben Barkley Dr, Suite 103Paducah, KY 42001-6789 · (270) 442-9461 · Fax (270) 441-0079
Phone(618) 997-6800
Fax(618) 997-1187
Sole ProprietorNo
Enumeration DateNovember 18, 2009
Last NPPES UpdateFebruary 23, 2017
✔ NPI 1154659894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KY · TC051
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
510 LINCOLN DR, Herrin, IL 62948
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Hollis Johnson Clark Jr. P.a.-c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.72
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC
Clinic/Center (Ambulatory Surgical)
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-3100
JARED JONES
Physical Therapist
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
MRS. KELLY JACKSON JOHNSON PA-C
Physician Assistant
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
GRETCHEN B MASON PA-C
Physician Assistant
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
MRS. MESHIA K HUGHES PA-C
Physician Assistant
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
TRAVIS C CHAPMAN PT
Physical Therapist
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
DAVID COLLIN PRATHER
Physical Therapist
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 997-6800
JOAN K. SCHULLIAN CRNA
Nurse Anesthetist, Certified Registered
510 LINCOLN DR
HERRIN, IL 62948
Williamson County (618) 457-5111

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 Hollis Clark's NPI number?

The NPI number for Hollis Clark is 1154659894. It was assigned to this individual provider in the NPPES registry on November 18, 2009.

Where is Hollis Clark located?

Hollis Clark practices at 510 Lincoln Dr, Herrin, IL 62948. The listed phone number is (618) 997-6800.

What is Hollis Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Hollis Clark enrolled in Medicare?

Yes. Hollis Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Hollis Clark was last updated on February 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.