Organization Active NPI

Ca Group LLC

  • Cardiovascular Disease Physician
  • Belleville, IL
National Provider Identifier
1689997280
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CA GROUP LLC
Practice address
4600 Memorial Drive
Ste. W-1
Belleville, IL 62226
Phone
(618) 233-3066
Fax
(618) 233-3180
NPI assigned
Mar 10, 2010
Last updated
Jul 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Authorized official

Name
Mr. James B. Davis, FACHE, MBA, MHSA
Title
Executive Director
Phone
(618) 257-6301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

4600 Memorial Drive
Ste. W-1
Belleville, IL 62226

Mailing address

4500 Memorial Drive
Medical Affairs Office
Belleville, IL 62226
Phone (618) 257-6568

National Provider Directory

National Provider Directory

Locations

4500 Memorial Dr
Ofc
Belleville, IL 62226
Phone (618) 257-5736

4550 Memorial Dr
Belleville, IL 62226
Phone (618) 233-0833

4550 Memorial Dr
Ste 320
Belleville, IL 62226
Phone (618) 233-0833

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1689997280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "address_2": "MEDICAL AFFAIRS OFFICE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-6568",
            "fax_number": "618-257-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DRIVE",
            "address_2": "STE. W-1",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-233-3066",
            "fax_number": "618-233-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CA GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2012-07-23",
        "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": "618-257-6301",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE, MBA, MHSA"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.