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SHAWNEE HEALTH CARE, CARBONDALE DENTAL
NPI 1174859870
Clinic/Center - Federally Qualified Health Center (FQHC) in Carbondale, IL

Active since October 30, 2009
402 S. LEWIS LANE, CARBONDALE, IL 62901(618) 519-9901 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 4, 2024, Dec 23, 2016, Aug 12, 2016 and 1 more (4 updates tracked since 2015).

About Shawnee Health Care, Carbondale Dental NPPES

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

SHAWNEE HEALTH CARE, CARBONDALE DENTAL (NPI 1174859870) is a healthcare organization registered as a federally qualified health center (fqhc) in Carbondale, Illinois and active in the NPI registry since October 2009. The organization lists Christina Carney, Ceo, as its authorized official.

NPPES Registry Identity

NPI1174859870
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSHAWNEE HEALTH SERVICE & DEVELOPMENT CORP
Location Address402 S. LEWIS LANECarbondale, IL 62901
Mailing Address109 California St, Po Box 577Carterville, IL 62918-1923 · (618) 985-8221 · Fax (618) 985-6860
Phone(618) 519-9901
Organization SubpartYesParent: Shawnee Health Service And Development Corp
Authorized OfficialChristina CarneyCeo · (618) 956-9521
Enumeration DateOctober 30, 2009
Last NPPES UpdateApril 4, 20244 updates tracked since enumeration
NPPES CertifiedApril 4, 2024
✔ NPI 1174859870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedDentistTaxonomy 122300000X
Also ListedDentist · Pediatric DentistryTaxonomy 1223P0221X
Also ListedDental HygienistTaxonomy 124Q00000X
Also ListedDental AssistantTaxonomy 126800000X
402 S. LEWIS LANE, Carbondale, IL 62901
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Other Names 1

Doing Business AsShawnee Health Care, Carbondale Dental

Other Identifiers 6

Medicaid019028144IL
Medicaid019027984IL
Medicaid019028085IL
Medicaid019028089IL
Medicaid019028149IL
Medicaid019028752IL

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

Other Providers at the Same Location NPPES

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

TERRY POWERS DMD
Dentist (General Practice)
402 S. LEWIS LANE
CARBONDALE, IL 62901
Jackson County (618) 519-9901

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 & Development Corp's NPI number?

The NPI number for Shawnee Health Service & Development Corp is 1174859870. It was assigned to this organization in the NPPES registry on October 30, 2009. The provider is doing business as Shawnee Health Care, Carbondale Dental.

Where is Shawnee Health Service & Development Corp located?

Shawnee Health Service & Development Corp is located at 402 S. Lewis Lane, Carbondale, IL 62901. The listed phone number is (618) 519-9901.

What is Shawnee Health Service & 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.

When was this NPI record last updated?

The NPPES record for Shawnee Health Service & Development Corp was last updated on April 4, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.