Active NPI
Gregory J Maag, Ma-Ccca Mid America Audiology Group, LTD
- Audiologist
- Alton, IL
National Provider Identifier
1720139967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 357528445001 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Audiologist
- Swansea, IL
- NPI 1235319245
-
- Audiologist
- Alton, IL
- NPI 1790262699
-
- Audiologist
- Augusta, GA
- NPI 1235301771
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.