Midwest Anesthesia Associates, P.C.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

MIDWEST ANESTHESIA ASSOCIATES, P.C.

Practice address

1 Memorial Dr
Alton, IL 62002-6722

Phone

(865) 293-5676

Fax

(865) 291-3239

NPI assigned

Jun 23, 2016

Organization subpart

No

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

Authorized official

Name

Stephen Holtzclaw, M.D.

Title

President

Phone

(865) 293-5676

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Midwest Anesthesia Associates, P.C.

  • Pain Medicine Physician
  • Saint Louis, MO
  • NPI 1558719617

  O20161221000252

  Same enrollment

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1205287083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984",
            "telephone_number": "865-293-5676",
            "fax_number": "865-291-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "865-293-5676",
            "fax_number": "865-291-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ANESTHESIA ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "HOLTZCLAW",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-293-5676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nada Memon, MD
• Brittany N Meredith, MA, LCPC
• Patricia Meyer
• Ashley Marie Meyers, DMD
• Midwest Acute Care Consultants PC
• Susan M Mielke, D.MIN. LCPC (IL)
• Dunya Mikhayel
• Dia M Milazzo, CRNA
• Dawn E Milburn, LPC, LCPC
• D Douglas Miley, D.M.D.

• Pain Medicine Physician in Alton, IL
• Providers in Alton, IL by specialty
• Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.