Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jerry Priddy, PA-C

Individual provider Surgical Physician Assistant · NPI 1003351115

Jerry Priddy, PA-C is a Physician Assistant in Springfield, Illinois. Qualified in 2016, 10 years ago. Practices with SIU Physicians and Surgeons Inc, a 316-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

619 E Mason St Ste 5
Springfield, IL 62701-1080
Phone: (217) 545-8000
Fax: (217) 545-2552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1301 S Koke Mill Rd, Springfield, IL 62711 — (217) 547-9100
  • 1301 S Koke Mill Rd, Springfield, IL 62711 — (217) 547-9100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085006117 (IL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 085006117 (IL)

Record details

NPI number1003351115
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 28, 2016
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Siu Physicians And Surgeons Inc — 316 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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