Active NPI
Layne T. Lovell, M.D.
- Family Medicine Physician
- Peoria, IL
National Provider Identifier
1366485906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036062930
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 655-2000
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- 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 | 036062930 | IL | Primary |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
2026 W Gerald Dr
Peoria, IL 61615-1188
Phone (309) 243-2544
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L06674 | Medicaid | IL | |
| 809840032 | Other | IL | INDIVIDUAL MEDICARE # |
| 809840 | Other | IL | MEDICARE GROUP # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients |
Locations
525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Macomb, IL
- NPI 1013048982
-
- Anatomic Pathology & Clinical Pathology Physician
- Macomb, IL
- NPI 1396055869
-
- General Acute Care Hospital
- Macomb, IL
- NPI 1629227665
-
- General Acute Care Hospital
- Macomb, IL
- NPI 1669420766
-
- General Acute Care Hospital
- Macomb, IL
- NPI 1790934735
-
- Certified Registered Nurse Anesthetist
- Macomb, IL
- NPI 1871704874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1366485906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2026 W GERALD DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616151188",
"telephone_number": "309-243-2544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001",
"telephone_number": "309-655-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVELL",
"first_name": "LAYNE",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036062930",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "L06674",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL MEDICARE #",
"identifier": "809840032",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "809840",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.