Organization Active NPI

Gregory J Maag, Ma-Ccca Mid America Audiology Group, LTD

  • Audiologist
  • Alton, IL
National Provider Identifier
1720139967
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
GREGORY J MAAG, MA-CCCA MID AMERICA AUDIOLOGY GROUP, LTD
Practice address
1417 Washington Ave
Ste 2
Alton, IL 62002-3964
Phone
(618) 462-7900
NPI assigned
Jan 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Mr. Gregory J Maag, MA-CCCA
Title
President
Phone
(618) 462-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X IL Primary

Addresses

Primary practice location

1417 Washington Ave
Ste 2
Alton, IL 62002-3964

Mailing address

1417 Washington Ave
Ste 2
Alton, IL 62002-3964
Phone (618) 462-7900

Other identifiers 1

IdentifierTypeStateIssuer
357528445001MedicaidIL

National Provider Directory

National Provider Directory

Locations

1417 Washington Ave
Ste 2
Alton, IL 62002
Phone (618) 462-7900

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1720139967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 WASHINGTON AVE",
            "address_2": "STE 2",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023964",
            "telephone_number": "618-462-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 WASHINGTON AVE",
            "address_2": "STE 2",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023964",
            "telephone_number": "618-462-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY J MAAG, MA-CCCA MID AMERICA AUDIOLOGY GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "MAAG",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-462-7900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA-CCCA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357528445001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.