Individual provider Active NPI

Elvira Salarda, MD

  • Family Medicine Physician
  • Sparta, IL
National Provider Identifier
1114984283
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036084662 Issued in IL
Practice address
Sparta Medical Office
215 South Burns
Sparta, IL 62286
Phone
(618) 443-4889
NPI assigned
May 1, 2006
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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 036084662 IL Primary

Addresses

Primary practice location

Sparta Medical Office
215 South Burns
Sparta, IL 62286

Mailing address

Sparta Medical Office
215 South Burns
Sparta, IL 62286
Phone (618) 443-4889

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smo@spartahospital.hin.us

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
I20060314000406 IL Practitioner - Family Practice 7719994854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084662ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1114984283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SPARTA MEDICAL OFFICE",
            "address_2": "215 SOUTH BURNS",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "62286",
            "telephone_number": "618-443-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPARTA MEDICAL OFFICE",
            "address_2": "215 SOUTH BURNS",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "62286",
            "telephone_number": "618-443-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALARDA",
        "first_name": "ELVIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036084662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smo@spartahospital.hin.us",
            "affiliation": "N",
            "address_1": "Sparta Medical Office",
            "address_2": "215 South Burns",
            "city": "Sparta",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sparta, IL

Sources for this page

Verify at the official NPI Registry.