Individual provider Active NPI

James S Powell, MD

  • Anesthesiology Physician
  • Maryville, IL
National Provider Identifier
1497726251
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036111788 Issued in IL
Practice address
6800 State Route 162
Dept. of Anesthesiology
Maryville, IL 62062-8500
Phone
(618) 288-5711
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2005015447 MO
Anesthesiology Physician 207L00000X 036111788 IL Primary

Addresses

Primary practice location

6800 State Route 162
Dept. of Anesthesiology
Maryville, IL 62062-8500

Mailing address

6 White Fang Dr
Glen Carbon, IL 62034-1397
Phone (618) 288-0938

Other identifiers 1

IdentifierTypeStateIssuer
207401001MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102001419 IL Practitioner - Anesthesiology 1456387943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Anesthesiology Consultants LLCGroup PAC ID 2961974944, 5 clinicians
Millennium Anesthesiology Consultants, LLCGroup PAC ID 9133250475, 17 clinicians

Practice addresses (Care Compare)

144 E Eatherton Rd
3Rd Floor
Chesterfield, MO 63005-4016
Phone (314) 492-1112

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Anesthesiology Consultants, LLC Anesthesiology CurrentSince Mar 22, 2010 Accepting new patients

Locations

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1497726251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WHITE FANG DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341397",
            "telephone_number": "618-288-0938",
            "fax_number": "618-288-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 STATE ROUTE 162",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628500",
            "telephone_number": "618-288-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2005015447",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036111788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207401001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.