Individual provider Active NPI

Larry Michael Newell, MD

  • Dermatology Physician
  • Springfield, IL
National Provider Identifier
1942386677
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Practice address
2951 Montvale Dr
Suite B
Springfield, IL 62704-5341
Phone
(217) 726-6429
Fax
(217) 726-6786
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X IL Primary

Addresses

Primary practice location

2951 Montvale Dr
Suite B
Springfield, IL 62704-5341

Mailing address

2951 Montvale Dr
Suite B
Springfield, IL 62704-5341
Phone (217) 726-6429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1942386677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 MONTVALE DR",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045341",
            "telephone_number": "217-726-6429",
            "fax_number": "217-726-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 MONTVALE DR",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045341",
            "telephone_number": "217-726-6429",
            "fax_number": "217-726-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWELL",
        "first_name": "LARRY",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.