NPIMap

Organization Active NPI

Integrated Medical Group, LTD

  • Customized Equipment (DME)
  • Edwardsville, IL
National Provider Identifier
1023175098
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
INTEGRATED MEDICAL GROUP, LTD
Practice address
435-B South Buchanan St
Edwardsville, IL 62025-2091
Phone
(618) 692-6700
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Authorized official

Name
Dr. David Michael Thayer, DCNPI 1689642951
Title
Owner
Phone
(618) 654-3900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

435-B South Buchanan St
Edwardsville, IL 62025-2091

Mailing address

PO Box 997
Edwardsville, IL 62025-0997
Phone (618) 692-6700

National Provider Directory

National Provider Directory
Tax ID family
Integrated Medical Group LTD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1023175098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250997",
            "telephone_number": "618-692-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435-B SOUTH BUCHANAN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252091",
            "telephone_number": "618-692-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "THAYER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-654-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.