Individual provider Active NPI

Ramesh Babu Vemuri, M.D.

  • Psychiatry Physician
  • Crystal Lake, IL
National Provider Identifier
1164508149
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036054365 Issued in IL
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

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036054365OtherILPHYSICIAN 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.054365ILMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montes Psychiatric Center, P.C. Psychiatry CurrentSince Nov 15, 2021 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.

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.

Verify at the official NPI Registry.