Individual provider Active NPI

Laura Smith, MD

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1750518775
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036131208 Issued in IL
Practice address
815 Main St Ste a
Peoria, IL 61602
Phone
(309) 672-4977
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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 036131208 IL Primary

Addresses

Primary practice location

815 Main St Ste a
Peoria, IL 61602

Mailing address

815 Main St Ste a
Peoria, IL 61602-1080
Phone (309) 672-4977

Other practice location 1

837 E Orange St
Hoopeston, IL 60942-1802
Phone (217) 283-5530

Other identifiers 1

IdentifierTypeStateIssuer
036131208001MedicaidIL

Other names 1

  • Laura Petrea Former name

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
I20121119000080 IL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 7719138841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak
Peoria, IL 61636
Phone (309) 672-5522

221 NE Glen Oak Ave
Peoria, IL 61636-0001

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 3, 2017 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Dec 30, 2025 Accepting new patients
Methodist Medical Center of Illinois Family Medicine Past Accepting new patients

Locations

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A1
Peoria, IL 61602

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: lsmithmd394073@carlehiedirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1750518775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021080",
            "telephone_number": "309-672-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61602",
            "telephone_number": "309-672-4977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "837 E Orange St",
            "address_purpose": "LOCATION",
            "city": "Hoopeston",
            "state": "IL",
            "postal_code": "609421802",
            "country_code": "US",
            "telephone_number": "217-283-5530",
            "fax_number": "217-283-6437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131208001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "PETREA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.