Associated Physicians Group LTD

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

A5100 Issued in IL

Legal business name

ASSOCIATED PHYSICIANS GROUP LTD

Practice address

4414 W Center Dr
Alton, IL 62002-5932

Phone

(618) 509-4870

Fax

(618) 509-4871

NPI assigned

Jun 18, 2015

Organization subpart

No

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

Authorized official

Name

John S Vick, DC

Title

Owner

Phone

(618) 628-8211

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1013398718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 W CENTER DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025932",
            "telephone_number": "618-509-4870",
            "fax_number": "618-509-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED PHYSICIANS GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-628-8211",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "A5100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamawak Seifemichael Anota, MD
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• Emily Rae Ashby, CRNA
• Stephanie Ashford, PTA
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• Juletta Avagyan, M.D.

• All providers in Alton, IL
• Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.