SHOSHANA B CHURCH (PA) – Physician Assistant, NPI 1548261449
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for SHOSHANA B CHURCH (PA)
1006, South Division Street, Carterville, Williamson County, Illinois, 62918, United States
CARTERVILLE, IL 629181539
Phone: (618) 985-4841
Fax: (618) 985-8101
Type: Location
P O BOX 577
109 CALIFORNIA
CARTERVILLE, IL 629180577
Phone: (618) 985-8221
Fax: (618) 985-4635
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $523.
Total Amount is formed as General ($523) + Research ($0) + Ownership ($0) = $523.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Alkermes, Inc. ($273).
Total Amount
$523
General + Research + Ownership
Payments
18
Total payment records
General Amount
$523
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $273 |
| ABBVIE INC. | $215 |
| PFIZER INC. | $22 |
| Otsuka America Pharmaceutical, Inc. | $14 |
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: 2004-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20040312000139 | I | Physician Assistant | IL | 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 62918)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL |
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