NPIMap

Organization Active NPI

Msa Alliance, LLC

  • Nephrology Physician
  • Breese, IL
National Provider Identifier
1467792960
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036121947 Issued in IL
Legal business name
MSA ALLIANCE, LLC
Practice address
160 N Main St
Breese, IL 62230-1630
Phone
(618) 234-8246
NPI assigned
Feb 20, 2013
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MSA ALLIANCE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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
Nephrology Physician 207RN0300X 036121947 IL Primary

Addresses

Primary practice location

160 N Main St
Breese, IL 62230-1630

Mailing address

4500 Memorial Dr
Medical Affairs Credentialing Dept
Belleville, IL 62226-5360
Phone (618) 257-4644

National Provider Directory

National Provider Directory
Tax ID family
Msa Alliance LLC Dba Pulmonary Physicians of Southern Illinois45 organizations share this tax ID, including this one
Part of
Msa Alliance LLC Dba Pulmonary Physicians of Southern Illinois

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": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1467792960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "address_2": "MEDICAL AFFAIRS CREDENTIALING DEPT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "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": "160 N MAIN ST",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622301630",
            "telephone_number": "618-234-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSA ALLIANCE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MSA ALLIANCE, LLC",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-28",
        "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": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036121947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.