Ernest E Ertmoed, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

036062213 Issued in IL

Practice address

1250 Churchill Rd
Springfield, IL 62702-3493

Phone

(217) 546-7556

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1710073382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 CHURCHILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023493",
            "telephone_number": "217-546-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 CHURCHILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023493",
            "telephone_number": "217-546-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTMOED",
        "first_name": "ERNEST",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036062213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ernestertmoed@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "900 N. 1st Street",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Gynecology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.