Individual provider Active NPI

Laura M Winkleman, MD

  • Family Medicine Physician
  • Harrisburg, IL
National Provider Identifier
1558331207
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036112962 Issued in IL
Practice address
117 E Clark St
Harrisburg, IL 62946-2702
Phone
(618) 252-8625
Fax
(618) 351-4859
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036112962 IL Primary

Addresses

Primary practice location

117 E Clark St
Harrisburg, IL 62946-2702

Mailing address

PO Box 3398
Carbondale, IL 62902-3398
Phone (618) 457-5200

Other identifiers 1

IdentifierTypeStateIssuer
036112962MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwinkleman13727@sih.direct-ci.com

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
I20050818000535 IL Practitioner - Family Practice 6901865450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrisburg Family Practice LTDGroup PAC ID 2163491564, 18 clinicians

Practice addresses (Care Compare)

117 E Clark St
Harrisburg, IL 62946-2702

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Feb 1, 2014 Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625

Interoperability endpoints

  • Direct secure messaging: lwinkleman13727@sih.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1558331207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3398",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023398",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-351-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKLEMAN",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112962",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwinkleman13727@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "117 E Clark St",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

Verify at the official NPI Registry.