NPIMap

Organization Active NPI

Visidoc, LLC

  • Family Medicine Physician
  • East Peoria, IL
National Provider Identifier
1932831427
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISIDOC, LLC
Practice address
111 W Washington St Ste 310
East Peoria, IL 61611-2559
Phone
(309) 699-4715
NPI assigned
Jun 24, 2022
Last updated
Mar 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Karen Sedgwick, CRNANPI 1881619963
Title
Vice President
Phone
(309) 699-4715

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

111 W Washington St Ste 310
East Peoria, IL 61611-2559

Mailing address

111 W Washington St Ste 310
East Peoria, IL 61611-2559
Phone (309) 699-4715

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CureMD Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

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": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1932831427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST STE 310",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112559",
            "telephone_number": "309-699-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST STE 310",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112559",
            "telephone_number": "309-699-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIDOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-24",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "SEDGWICK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "309-699-4715",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CureMD",
            "affiliation": "N",
            "endpointDescription": "Cloud Based Patient Software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF/word",
            "address_1": "111 W Washington St Ste 310",
            "city": "East Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616112559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

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