Active NPI
Laura Lee Loesel, M.D.
- Family Medicine Physician
- Springfield, IL
National Provider Identifier
1295827566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-113362
- Practice address
- 520 N 4TH St
Springfield, IL 62702-5238 - Phone
- (217) 757-8100
- Fax
- (217) 747-1351
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-113362 | IL | Primary |
Addresses
Primary practice location
520 N 4TH St
Springfield, IL 62702-5238
Mailing address
PO Box 19670
Springfield, IL 62794-9670
Phone (217) 757-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036113362 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-113362 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honorhealth Medical Group, LLC | Current | Accepting new patients |
Locations
2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462
Interoperability endpoints
- lloesel549638@direct.honorhealth.com
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Peoria, AZ
- NPI 1043851793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1295827566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19670",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949670",
"telephone_number": "217-757-8100",
"fax_number": "217-747-1351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N 4TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025238",
"telephone_number": "217-757-8100",
"fax_number": "217-747-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOESEL",
"first_name": "LAURA",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-113362",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036113362",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.