NPIMap

Organization Active NPI

Medvidi Health PC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1275390940
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MEDVIDI HEALTH PC
Practice address
230 E Ohio St # 410-1155
Chicago, IL 60611-3265
Phone
(504) 414-5095
NPI assigned
Feb 29, 2024
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Laura E PurdyNPI 1093058463
Title
Cmo
Phone
(910) 644-8373

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

230 E Ohio St # 410-1155
Chicago, IL 60611-3265

Mailing address

4010 Moorpark Ave Ste 114
San Jose, CA 95117-1804
Phone (415) 966-0848

National Provider Directory

National Provider Directory
Tax ID family
Medvidi Health PC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

4010 Moorpark Ave
Ste 114
San Jose, CA 95117

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1275390940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 MOORPARK AVE STE 114",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171804",
            "telephone_number": "415-966-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E OHIO ST # 410-1155",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113265",
            "telephone_number": "504-414-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDVIDI HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "PURDY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "910-644-8373"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.