Active NPI
Shady Georgy
- Neurology Physician
- Springfield, IL
National Provider Identifier
1316497902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 125068547
- Practice address
- 751 N Rutledge St
Springfield, IL 62702-4968 - Phone
- (217) 545-8000
- NPI assigned
- Oct 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 125068547 | IL | Primary |
Addresses
Primary practice location
751 N Rutledge St
Springfield, IL 62702-4968
Mailing address
751 N Rutledge St
Springfield, IL 62702-4968
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125068547 | IL | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1316497902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 N RUTLEDGE ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627024968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 N RUTLEDGE ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627024968",
"telephone_number": "217-545-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGY",
"first_name": "SHADY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-07",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "125068547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.