Organization Active NPI

Vyas Harshavadan J MD

  • Obstetrics & Gynecology Physician
  • Ottawa, IL
National Provider Identifier
1114290244
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036071120 Issued in IL
Legal business name
VYAS HARSHAVADAN J MD
Practice address
1013 Clinton St
Ottawa, IL 61350-2039
Phone
(815) 433-3331
Fax
(815) 433-3344
NPI assigned
Feb 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Dr. Harshavadan J Vyas, M.D..NPI 1841391950
Title
Physician/Owner
Phone
(815) 433-3331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 036071120 IL Primary

Addresses

Primary practice location

1013 Clinton St
Ottawa, IL 61350-2039

Mailing address

1013 Clinton St
Ottawa, IL 61350-2039
Phone (815) 433-3331

Other identifiers 2

IdentifierTypeStateIssuer
036071120MedicaidIL
500034350OtherILBLUECROSS BLUE SHIELD PROVIDER ID

National Provider Directory

National Provider Directory

Locations

1013 Clinton St
Ottawa, IL 61350
Phone (815) 433-3331

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1114290244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 CLINTON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502039",
            "telephone_number": "815-433-3331",
            "fax_number": "815-433-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 CLINTON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502039",
            "telephone_number": "815-433-3331",
            "fax_number": "815-433-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VYAS HARSHAVADAN J MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "HARSHAVADAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "815-433-3331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036071120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071120",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD PROVIDER ID",
            "identifier": "500034350",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.