NPIMap

Organization Active NPI

Ca Group, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Shiloh, IL
National Provider Identifier
1619327376
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
Legal business name
CA GROUP, LLC
Practice address
1404 Cross St
Suite 2940
Shiloh, IL 62269-2988
Phone
(618) 607-3700
Fax
(618) 624-4841
NPI assigned
Jun 14, 2016
Last updated
Jun 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X
Clinical Cardiac Electrophysiology Physician 207RC0001X Primary
Interventional Cardiology Physician 207RI0011X

Addresses

Primary practice location

1404 Cross St
Suite 2940
Shiloh, IL 62269-2988

Mailing address

4500 Memorial Drive
Memorial Hospital Credentialing Department
Belleville, IL 62226
Phone (618) 257-4644

National Provider Directory

National Provider Directory
Tax ID family
Ca Group LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1404 Cross St
Ste 2940
Shiloh, IL 62269
Phone (618) 233-3660

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1619327376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "address_2": "MEMORIAL HOSPITAL CREDENTIALING DEPARTMENT",
            "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": "1404 CROSS ST",
            "address_2": "SUITE 2940",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692988",
            "telephone_number": "618-607-3700",
            "fax_number": "618-624-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CA GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "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": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.