Bunker Hill Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036063415 Issued in IL

Legal business name

BUNKER HILL MEDICAL CLINIC

Practice address

144 North Washington Street
Bunker Hill, IL 62014

Phone

(618) 585-6290

Fax

(618) 585-6293

NPI assigned

Jul 23, 2007

Organization subpart

No

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

Authorized official

Name

Gregg L. Laws, M.D.NPI 1861598534

Title

Doctor

Phone

(618) 585-6290

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Bunker Hill Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gregg L Laws MD

  • Internal Medicine Physician
  • Carlinville, IL
  • NPI 1801096730
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregg L Laws, MD

  • Internal Medicine Physician
  • Carlinville, IL
  • NPI 1861598534
  NPD (past) Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1689874182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 323",
            "city": "BUNKER HILL",
            "state": "IL",
            "postal_code": "620140323",
            "telephone_number": "618-585-6290",
            "fax_number": "618-585-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 NORTH WASHINGTON STREET",
            "city": "BUNKER HILL",
            "state": "IL",
            "postal_code": "62014",
            "telephone_number": "618-585-6290",
            "fax_number": "618-585-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUNKER HILL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "LAWS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "618-585-6290",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036063415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9900567",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "C43578",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "134799",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063415",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Renee Brunaugh
• Bunker Hill Area Ambulance Service Inc.
• Bunker Hill Area Ambulance Service, Inc.
• Bunker Hill Area Ambulance SVC.
• Bunker Hill Community Unit No 8
• Care in the Heart of Home
• Darlene Louise Clark, D.M.D.
• Elizabeth L Conner, PHD CCC SLP
• Jamie Diesetlhorst
• Emma Gansz

• Internal Medicine Physician in Bunker Hill, IL
• Providers in Bunker Hill, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.