Edward Robert Nemergut, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

027803 Issued in CT

Practice address

112 Mansfield Ave
Willimantic, CT 06226-2041

Phone

(860) 456-6715

Fax

(860) 456-6771

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508810201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 CHAPEL ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141645",
            "telephone_number": "203-378-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-456-6715",
            "fax_number": "860-456-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMERGUT",
        "first_name": "EDWARD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "027803",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "027803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynette C Murray, CRNA
• Nadia S Nashid, MD
• Amanda Neal
• Dwayne A Nelson
• Kathryn Nelson, APRN
• New Way Dental SVCS LLC
• Donna Marie Nicolino, MSW
• Northeast Emergency Medicine Specialists, LLC
• Brooke Nye, M.S.ED., CCC-SLP
• Luke B O'Brien

• Internal Medicine Physician in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.