Individual provider Active NPI

Michael Paul Klingler, M.D.

  • Pediatrics Physician
  • Flora, IL
National Provider Identifier
1447450085
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036120528 Issued in IL
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

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080801000167 IL Practitioner - Pediatric Medicine 7416021936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036120528ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clay CurrentSince Jun 18, 2018 Accepting new patients
County of Clay Current Accepting new patients
County of Clay CurrentSince Jun 18, 2018 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

  • Direct secure messaging: mklin@yourcarecommunity.org
  • Direct secure messaging: 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.

FacilityTypeRoleSince
Clay Home Health ServicesFlora, IL, CCN 147086 Home health agency Operational/Managerial Control Nov 30, 2008
Clay County Health Department HospiceFlora, IL, CCN 141611 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.

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.

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

Verify at the official NPI Registry.