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JACQUELINE R CLAYTON APN
NPI 1821019969
Nurse Practitioner - Family in Shelbyville, IL

Active since July 22, 2006PECOS Enrolled
1215 W MAIN ST, SHELBYVILLE, IL 62565(217) 774-4305(217) 774-4306 Get Directions Write a Review

NPPES record last updated: January 15, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 15, 2020, Oct 1, 2019, Nov 16, 2018 and 1 more (4 updates tracked since 2018).

About Jacqueline R Clayton Apn NPPES

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

JACQUELINE R CLAYTON APN (NPI 1821019969) is an individual family provider in Shelbyville, Illinois, licensed in Illinois (277000144) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1821019969
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACQUELINE R CLAYTONCredential: APN
Location Address1215 W MAIN STShelbyville, IL 62565-1252
Mailing Address1005 Health Center Dr Ste 201Mattoon, IL 61938-4693 · (217) 238-6055
Phone(217) 774-4305
Fax(217) 774-4306
Sole ProprietorNo
Enumeration DateJuly 22, 2006
Last NPPES UpdateJanuary 15, 20204 updates tracked since enumeration
✔ NPI 1821019969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IL · 277000144✔ Licensed in IL · 209-006100
1215 W MAIN ST, Shelbyville, IL 62565
Open in Google Maps ↗

Secondary Practice Locations 4

Location 12040 Lincoln Ave Ste 100Charleston, IL 61920-3197 · Phone (217) 345-2030
Location 2200 Dettro DrMattoon, IL 61938-9003 · Phone (217) 238-3000
Location 3905 N Maple StEffingham, IL 62401-6401 · Phone (217) 540-6123 · Fax (217) 347-7197
Location 47 Hawthorne Lane, SBL Sullivan ClinicSullivan, IL 61951 · Phone (217) 543-3444

Other Identifiers 1

Medicaid309003069IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline R Clayton Apn 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.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Clayton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sarah Bush Lincoln Health Center
29 mi
Family Medicine
1000 HEALTH CENTER DR
Mattoon, IL 61938
  • Reassigned Medicare billing, Illinois enrollment
  • 652 clinicians in this Medicare group
NPI 1568581379 (217) 258-2525

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62565 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
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

DR. DORIS ANN BOWERS M.D.
Family Medicine
1215 W MAIN ST
SHELBYVILLE, IL 62565
Shelby County (217) 774-4305
KRISTIN MARIE HAAG PA-C
Physician Assistant
1215 W MAIN ST
SHELBYVILLE, IL 62565
Shelby County (217) 774-4305
SAMIHA MCCONNELL APRN
Nurse Practitioner (Family)
1215 W MAIN ST
SHELBYVILLE, IL 62565
Shelby County (217) 774-4305
MR. GARY D HAYDEN PA-C
Physician Assistant
1215 W MAIN ST
SHELBYVILLE, IL 62565
Shelby County (217) 774-4305

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 Jacqueline Clayton's NPI number?

The NPI number for Jacqueline Clayton is 1821019969. It was assigned to this individual provider in the NPPES registry on July 22, 2006.

Where is Jacqueline Clayton located?

Jacqueline Clayton practices at 1215 W Main St, Shelbyville, IL 62565. The listed phone number is (217) 774-4305.

What is Jacqueline Clayton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacqueline Clayton enrolled in Medicare?

Yes. Jacqueline Clayton is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Clayton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Clayton reassigns Medicare benefits to Sarah Bush Lincoln Health Center (Mattoon, IL). The 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 Jacqueline Clayton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Clayton was last updated on January 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.