Individual provider Active NPI

Vera Nemsadze, M.D.

  • Neurology Physician
  • Springfield, IL
National Provider Identifier
1194560516
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
125.084248 Issued in IL
Practice address
751 N Rutledge
3Rd Floor
Springfield, IL 62702
Phone
(217) 545-8000
Fax
(217) 545-4282
NPI assigned
Jun 27, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 125.084248 IL Primary

Addresses

Primary practice location

751 N Rutledge
3Rd Floor
Springfield, IL 62702

Mailing address

P.O. Box 19643
Springfield, IL 62794
Phone (217) 545-8000

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
I20240731002693 IL Order and Referring Only - NeurologyPractitioner - Neurology 7810434487

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.084248ILMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1194560516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 19643",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62794",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE",
            "address_2": "3RD FLOOR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMSADZE",
        "first_name": "VERA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125.084248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.