Individual provider Active NPI

Lawrence Atherton, M.D.

  • Cardiovascular Disease Physician
  • Champaign, IL
National Provider Identifier
1124033642
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-078664 Issued in IL
Practice address
101 W University Ave
Champaign, IL 61820-3981
Phone
(217) 366-1304
Fax
(217) 366-7427
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036-078664 IL Primary

Addresses

Primary practice location

101 W University Ave
Champaign, IL 61820-3981

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-2670

Other identifiers 3

IdentifierTypeStateIssuer
279500OtherILMEDICARE GROUP
060016815OtherILRAILROAD MEDICARE
036078664 1MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lathertonmd78466@Carle.ilhiedirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826000790 IL Practitioner - Cardiovascular Disease (Cardiology) 7517879125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-078664ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC Cardiovascular Disease CurrentSince Jan 1, 1987 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1207 S Mattis Ave
Champaign, IL 61821
Phone (217) 355-1684

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

Interoperability endpoints

  • Direct secure messaging: lathertonmd78466@carle.ilhiedirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1124033642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-2670",
            "fax_number": "217-366-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1304",
            "fax_number": "217-366-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHERTON",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-078664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "279500",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060016815",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078664 1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lathertonmd78466@Carle.ilhiedirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 W University Ave",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618203981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.