NPIMap

Organization Active NPI

Ca Group, LLC

  • Cardiovascular Disease Physician
  • Fairview Heights, IL
National Provider Identifier
1700189974
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CA GROUP, LLC
Practice address
317 Salem PL
Suite180
Fairview Heights, IL 62208-1367
Phone
(618) 628-8294
Fax
(618) 463-9093
NPI assigned
Dec 9, 2010
Last updated
Feb 21, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CA GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 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
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

317 Salem PL
Suite180
Fairview Heights, IL 62208-1367

Mailing address

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

National Provider Directory

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

Other organizations with this tax ID 9

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

Locations

317 Salem Pl
Ste 180
Fairview Hts, IL 62208
Phone (618) 206-4050

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1700189974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "address_2": "MEDICAL AFFAIRS CREDENTIALING DEPARTMENT",
            "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": "317 SALEM PL",
            "address_2": "SUITE180",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081367",
            "telephone_number": "618-628-8294",
            "fax_number": "618-463-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CA GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CA GROUP, LLC",
        "enumeration_date": "2010-12-09",
        "last_updated": "2013-02-21",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.