Laura Burton

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209017788 Issued in IL

Practice address

203 E Ferguson Ave
Wood River, IL 62095-2001

Phone

(618) 254-2273

NPI assigned

Apr 9, 2019

Last updated

Apr 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 16, 2021 through Aug 16, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Morningstar Chiropractic & Rehabilitation Center LTD

  • Chiropractor
  • Glen Carbon, IL
  • NPI 1467460733
  NPD
• Ican Clinic LLC

  dba Wood River Chiropractic

  • Multi-Specialty Clinic/Center
  • Edwardsville, IL
  • NPI 1669722872
  NPD (past)

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1417410200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E FERGUSON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952001",
            "telephone_number": "618-254-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E FERGUSON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952001",
            "telephone_number": "618-254-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://icanclinic.org/",
            "affiliation": "N",
            "address_1": "203 E Ferguson Ave",
            "city": "Wood River",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620952001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beverly Enterprises - Illinois, Inc. (VIP Manor)
• Jared Andrew Blaylock, PHARMD
• Bravo Care of Wood River Inc
• Bria of Woodriver LP
• Bob Burris, M.D.
• Keith N Byler, D. O.
• Caldieraro Family Dentistry, PC
• Camp Drugs, Inc (camp drug store)
• Abigail Marie Cantalupo
• Andrew G. Carr, D.C.

• Nurse Practitioner in Wood River, IL
• Providers in Wood River, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.