Shawnee Health Service and Development Corp
NPI 1114631967 · Federally Qualified Health Center (FQHC) · Marion, IL
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shawnee Health Service and Development Corp is a Federally Qualified Health Center (FQHC) organization in Marion, IL (NPI 1114631967).
Provider details
- NPI number
- 1114631967
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Shawnee Health Service and Development Corp
- Organization subpart
- Yes
- Authorized official
- Christina Carney, Ceo(618) 956-9521
Specialties & taxonomies
Ambulatory Health Care Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- General Practice Dentistry1223G0001X
Dental Providers
- Dental Hygienist124Q00000X
Dental Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Jefferson Elementary School Health Center
- Doing business as
- Jefferson Elementary School Health Center
Registry dates
- Enumerated
- 2023-01-06
- Last updated
- 2024-07-29
- Certified
- 2024-07-29
Frequently asked questions
- What is Shawnee Health Service and Development Corp's NPI number?
- Shawnee Health Service and Development Corp's National Provider Identifier (NPI) is 1114631967, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shawnee Health Service and Development Corp?
- Shawnee Health Service and Development Corp is classified in the NPPES registry as Federally Qualified Health Center (FQHC) (Ambulatory Health Care Facilities).
- Where is Shawnee Health Service and Development Corp located?
- Shawnee Health Service and Development Corp's practice location on file with NPPES is 700 E Boulevard St, Marion, IL 62959-3306.
- What is Shawnee Health Service and Development Corp's phone number?
- The practice phone number listed in the NPPES registry for Shawnee Health Service and Development Corp is (618) 519-9200.
- Does Shawnee Health Service and Development Corp accept Medicare?
- Shawnee Health Service and Development Corp is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Shawnee Health Service and Development Corp?
- The authorized official listed on Shawnee Health Service and Development Corp's NPPES record is Christina Carney, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shawnee Health Service and Development Corp's NPI active?
- Yes — Shawnee Health Service and Development Corp's NPI (1114631967) is active in the NPPES registry as of the last update on 2024-07-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.