JACQUELINE R CLAYTON (APN) – Family Nurse Practitioner, NPI 1821019969
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JACQUELINE R CLAYTON (APN)
200 Dettro Dr
Mattoon, IL 619389003
Phone: (217) 238-3000
Type: Location
2040 Lincoln Ave Ste 100
Charleston, IL 619203197
Phone: (217) 345-2030
Type: Location
905 N Maple St
Effingham, IL 624016401
Phone: (217) 540-6123
Fax: (217) 347-7197
Type: Location
7 Hawthorne Lane
SBL Sullivan Clinic
Sullivan, IL 61951
Phone: (217) 543-3444
Type: Location
1005 HEALTH CENTER DR STE 201
MATTOON, IL 619384693
Phone: (217) 238-6055
Type: Mailing
1215, West Main Street, Shelbyville, Shelby County, Illinois, 62565, United States
SHELBYVILLE, IL 625651252
Phone: (217) 774-4305
Fax: (217) 774-4306
Type: Location
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: 2006-10-02
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 |
|---|---|---|---|---|
| I20061002000035 | I | Nurse Practitioner | 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 61938)
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