SHANNON WATLEY (DO) – Obstetrics & Gynecology Physician, NPI 1205821121
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,923 OBSTETRICS/GYNECOLOGY in IL
Provider Addresses for SHANNON WATLEY (DO)
1000 Health Center Dr
Mattoon, IL 619384644
Phone: (217) 238-4325
Fax: (217) 348-4290
Type: Location
West Jackson Street, Woodstock, McHenry County, Illinois, 60098, United States
WOODSTOCK, IL 600983188
Phone: (815) 337-1871
Fax: (815) 338-6297
Type: Mailing
360 STATION DRIVE
3RD FLOOR
CRYSTAL LAKE, IL 600146260
Phone: (815) 477-2310
Fax: (815) 356-2335
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Organon LLC ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-10-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040830000244 | I | Obstetrics/Gynecology | IL | TBD |
| I20221031001037 | I | Obstetrics/Gynecology | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61938)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL |
Reviews
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