NPIMap

Organization Active NPI

PC Associates, LLC

  • Family Medicine Physician
  • Swansea, IL
National Provider Identifier
1629443601
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PC ASSOCIATES, LLC
Practice address
3 Park PL
Swansea, IL 62226-2965
Phone
(618) 277-4888
Fax
(618) 277-1190
NPI assigned
Dec 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3 Park PL
Swansea, IL 62226-2965

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
PC Associates LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1629443601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE- MEDICAL AFFAIR",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PARK PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262965",
            "telephone_number": "618-277-4888",
            "fax_number": "618-277-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.