CLINT ANTHONY (MD) – Psychiatry Physician, NPI 1922111657

CLINT ANTHONY (MD) is a healthcare provider. based in Centralia, Illinois. specializing in PSYCHIATRY, GERIATRIC PSYCHIATRY. They hold the professional credentials MD. They hold a License No. G85401 (CA). The NPI Number for CLINT ANTHONY (MD) is 1922111657

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
CLINT ANTHONY (MD)
NPI
1922111657
Phone
(618) 436-5665
Address
444 N Pleasant Ave
Enumeration Date
16 August 2006
Last Update Date
10 November 2020

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6023446550
Graduation Year
1989 (37 years ago)
PAC ID
3375977457
Group Practice PAC ID
4688583651
Professional Enrollment ID
I20200521001768
Address ID
AZ850041844PH1101XAVEX402
Telehealth
Yes

Contacts

FHIR Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Secure Messaging
canthony341256@direct-ehr-ssmhc.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

1,367 PSYCHIATRY in IL

Provider Addresses for CLINT ANTHONY (MD)

  • 444 N Pleasant Ave

    Centralia, IL 628013006

    Phone: (618) 436-5665

    Type: Location

  • Carl T. Hayden Veterans Affairs Medical Center, 650, East Indian School Road, Phoenix, Maricopa County, Arizona, 85012, United States

    PHOENIX, AZ 850121839

    Phone: (602) 222-2752

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2020-05-21

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200521001768IPsychiatryAZTBD

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.

Verify on CMS Revalidation Lookup Tool

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 62801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688583651View full group profile

Reviews

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Frequently asked questions

What is CLINT ANTHONY (MD)'s NPI number?
CLINT ANTHONY (MD)'s NPI is 1922111657 — the number used across U.S. healthcare to identify this provider.
Is CLINT ANTHONY (MD) still an active registrant?
CLINT ANTHONY (MD) carries an active NPI according to the public dataset.
How would a patient describe CLINT ANTHONY (MD)'s focus?
For CLINT ANTHONY (MD), the primary taxonomy reads as Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with CLINT ANTHONY (MD)?
Directory geography for CLINT ANTHONY (MD) centers on Centralia, Illinois.
Does CLINT ANTHONY (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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