NPIMap

Organization Active NPI

Msa Alliance, LLC

  • Vascular Surgery Physician
  • Alton, IL
National Provider Identifier
1093258154
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MSA ALLIANCE, LLC
Practice address
2 Memorial Dr
Suite 201
Alton, IL 62002-6723
Phone
(618) 222-1020
Fax
(618) 222-1039
NPI assigned
Nov 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2 Memorial Dr
Suite 201
Alton, IL 62002-6723

Mailing address

4500 Memorial Drive
Memorial Hospital Medical Affairs Credentialing Dept
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

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1093258154",
    "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 CREDENTIALING DEPT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-4644",
            "fax_number": "618-257-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR",
            "address_2": "SUITE 201",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026723",
            "telephone_number": "618-222-1020",
            "fax_number": "618-222-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSA ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2016-11-22",
        "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"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.