Organization Active NPI

Midwest OBGYN & Infertility Center

  • Obstetrics & Gynecology Physician
  • Decatur, IL
National Provider Identifier
1104173533
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036084779 Issued in IL
Legal business name
MIDWEST OBGYN & INFERTILITY CENTER
Practice address
675 E Snyder Dr Ste 1
Decatur, IL 62526-4766
Phone
(217) 875-1886
Fax
(217) 875-3120
NPI assigned
Aug 3, 2012
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Dr. Vidya Sagar Rao Morisetty, M.D.
Title
Owner
Phone
(217) 875-1886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036084779 IL Primary

Addresses

Primary practice location

675 E Snyder Dr Ste 1
Decatur, IL 62526-4766

Mailing address

675 E Snyder Dr Ste 1
Decatur, IL 62526-4766
Phone (217) 875-1886

National Provider Directory

National Provider Directory

Locations

675 E Snyder Dr
Decatur, IL 62526

675 E Snyder Dr
Ste 1
Decatur, IL 62526
Phone (217) 875-1886

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16757/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1104173533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 E SNYDER DR STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264766",
            "telephone_number": "217-875-1886",
            "fax_number": "217-875-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 E SNYDER DR STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264766",
            "telephone_number": "217-875-1886",
            "fax_number": "217-875-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST OBGYN & INFERTILITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "MORISETTY",
        "authorized_official_first_name": "VIDYA",
        "authorized_official_middle_name": "SAGAR RAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-875-1886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036084779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.