Lincoln Trail Orthopaedic Clinic, S.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036058473 Issued in IL

Legal business name

LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C.

Practice address

103 Professional PLZ
Mattoon, IL 61938-9252

Phone

(217) 348-1030

Fax

(217) 348-1090

NPI assigned

Apr 8, 2008

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Julee Lee

Title

Office Manager

Phone

(217) 348-1052

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly S Jones, RN

  • Registered Nurse First Assistant
  • Mattoon, IL
  • NPI 1336376433
  NPD (past)
• Michael Lee Steveley, PA-C

  • Physician Assistant
  • Logansport, IN
  • NPI 1134455298
  NPD (past)

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1366615668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PROFESSIONAL PLZ",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389252",
            "telephone_number": "217-348-1030",
            "fax_number": "217-348-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PROFESSIONAL PLZ",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389252",
            "telephone_number": "217-348-1030",
            "fax_number": "217-348-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JULEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-348-1052",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036058473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "133038",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1515701",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058473",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "791203439",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "002811",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis S Levitt, APRN
• Kay Lewis, B.S.
• Mallory Michelle Light, CRNA
• Kayla Lightwood
• Christopher Steven Lillie, PA-C
• Howard Lindecker, CRNA
• Emilie Lodes
• Lori D. Loop, R.N.
• Tegan Lovekamp
• Kiaya Loy, MS, MHP

• Orthopaedic Surgery Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.