Active NPI
Ramesh Babu Vemuri, M.D.
- Psychiatry Physician
- Crystal Lake, IL
National Provider Identifier
1164508149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036054365
- Practice address
- 145 S Virginia St
Crystal Lake, IL 60014-7226 - Phone
- (815) 444-9999
- Fax
- (815) 397-2712
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036054365 | IL | Primary |
| Community/Behavioral Health Agency | 251S00000X | |||
| Addiction Psychiatry Physician | 2084P0802X | 036.054365 | IL | |
| Geriatric Psychiatry Physician | 2084P0805X | 036.054365 | IL | |
| Pain Medicine (Psychiatry & Neurology) Physician | 2084P2900X | 036.054365 | IL | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
145 S Virginia St
Crystal Lake, IL 60014-7226
Mailing address
145 S Virginia St
Crystal Lake, IL 60014-7226
Phone (815) 444-9999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036054365 | Other | IL | PHYSICIAN LICENSE |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.054365 | IL | MD | Pain Medicine (Psychiatry & Neurology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montes Psychiatric Center, P.C. | Psychiatry | Current | Accepting new patients |
Locations
6090 Strathmoor Dr
Ste 1
Rockford, IL 61107
Phone (815) 444-9999
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Rockford, IL
- NPI 1629694278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1164508149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 S VIRGINIA ST",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147226",
"telephone_number": "815-444-9999",
"fax_number": "815-397-2712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 S VIRGINIA ST",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147226",
"telephone_number": "815-444-9999",
"fax_number": "815-397-2712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEMURI",
"first_name": "RAMESH",
"middle_name": "BABU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036054365",
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "IL",
"license": "036.054365",
"primary": false
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "IL",
"license": "036.054365",
"primary": false
},
{
"code": "2084P2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Pain Medicine",
"state": "IL",
"license": "036.054365",
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN LICENSE",
"identifier": "036054365",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.