NPIMap

Organization Active NPI

Msa Alliance, LLC

  • Vascular Surgery Physician
  • Maryville, IL
National Provider Identifier
1053711895
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MSA ALLIANCE, LLC
Practice address
2133 Vadalabene Dr
Suite 2
Maryville, IL 62062-5839
Phone
(618) 222-1020
Fax
(618) 222-1039
NPI assigned
Aug 29, 2014
Last updated
Aug 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Mr. James B. Davis
Title
Executive Director
Phone
(618) 257-4644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

2133 Vadalabene Dr
Suite 2
Maryville, IL 62062-5839

Mailing address

4500 Memorial Drive
Memorial Hospital Medical Affairs
Belleville, IL 62226
Phone (618) 257-4644

National Provider Directory

National Provider Directory
Tax ID family
Msa Alliance LLC45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

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": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1053711895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "address_2": "MEMORIAL HOSPITAL MEDICAL AFFAIRS",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 VADALABENE DR",
            "address_2": "SUITE 2",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625839",
            "telephone_number": "618-222-1020",
            "fax_number": "618-222-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSA ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-257-4644",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.