Active NPI
Michael Paul Klingler, M.D.
- Pediatrics Physician
- Flora, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036120528
- Practice address
- 929 Stacy Burk Drive
Flora, IL 62839-3241 - Phone
- (618) 662-2191
- NPI assigned
- Jul 23, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036120528 | IL | Primary |
Addresses
Primary practice location
929 Stacy Burk Drive
Flora, IL 62839-3241
Mailing address
3402 N Glenwood Rd
Noble, IL 62868-2423
Phone (618) 723-2435
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036120528 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Clay | Current | Accepting new patients | |
| County of Clay | Current | Accepting new patients | |
| County of Clay | Current | Accepting new patients | |
| County of Clay | Past | Accepting new patients |
Locations
939 Sunset Rd SW
Clay City, IL 62824
Phone (686) 662-2131
911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161
929 Stacey Burk Dr
Flora, IL 62839
Interoperability endpoints
- mklin@yourcarecommunity.org
- mklingler370831@direct-ehr-ssmhc.com
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Clay Home Health Services | Home health agency | Operational/Managerial Control | Nov 30, 2008 |
| Clay County Health Department Hospice | Hospice | Corporate Director | Nov 30, 2008 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Flora, IL
- NPI 1083799035
Operational/Managerial Control
-
- Community Based Hospice Care Agency
- Flora, IL
- NPI 1902975188
Corporate Director
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Flora, IL
- NPI 1811946411
-
- Critical Access Hospital
- Flora, IL
- NPI 1184655136
-
- Community/Retail Pharmacy
- Flora, IL
- NPI 1235990276
-
- Rural Health Clinic/Center
- Clay City, IL
- NPI 1871950550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1447450085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3402 N GLENWOOD RD",
"city": "NOBLE",
"state": "IL",
"postal_code": "628682423",
"telephone_number": "618-723-2435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 STACY BURK DRIVE",
"city": "FLORA",
"state": "IL",
"postal_code": "628393241",
"telephone_number": "618-662-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINGLER",
"first_name": "MICHAEL",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-23",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036120528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.