Individual provider Active NPI

Lauri F Lopp, MD

  • Family Medicine Physician
  • Springfield, IL
National Provider Identifier
1831189539
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-114958 Issued in IL
Practice address
520 N 4TH St
Springfield, IL 62702-5238
Phone
(217) 757-8100
Fax
(217) 757-8161
NPI assigned
Oct 24, 2005
Last updated
Aug 31, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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 036-114958 IL Primary

Addresses

Primary practice location

520 N 4TH St
Springfield, IL 62702-5238

Mailing address

PO Box 19670
Springfield, IL 62794-9670
Phone (217) 757-8100

Other identifiers 1

IdentifierTypeStateIssuer
036114958MedicaidIL

Other names 1

  • Lauri Jean Fick 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
I20061026000401 IL Practitioner - Family Practice 9133160351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114958ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Board of Trustees of Southern Illinois University Family Medicine Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2012 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2012 Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

Interoperability endpoints

  • Direct secure messaging: laurilopp@siusm.allscriptsdirect.net

Organizations & group practices 5

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 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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1831189539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19670",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949670",
            "telephone_number": "217-757-8100",
            "fax_number": "217-757-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025238",
            "telephone_number": "217-757-8100",
            "fax_number": "217-757-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPP",
        "first_name": "LAURI",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114958",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURI",
            "last_name": "FICK",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.