NPIMap

Organization Active NPI

Msa Alliance, LLC

  • Family Medicine Physician
  • Smithton, IL
National Provider Identifier
1760819676
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MSA ALLIANCE, LLC
Practice address
4017 Illinois Route 159,
Suite 101
Smithton, IL 62285
Phone
(618) 257-2875
Fax
(618) 257-2895
NPI assigned
Oct 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4017 Illinois Route 159,
Suite 101
Smithton, IL 62285

Mailing address

4500 Memorial Drive
Memorial Hospital Medical Affairs Credentialing Dept.
Belleville, IL 62226
Phone (618) 257-4644

National Provider Directory

National Provider Directory
Tax ID family
Msa Alliance LLC45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1760819676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "address_2": "MEMORIAL HOSPITAL MEDICAL AFFAIRS CREDENTIALING DEPT.",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "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": "4017 ILLINOIS ROUTE 159,",
            "address_2": "SUITE 101",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "62285",
            "telephone_number": "618-257-2875",
            "fax_number": "618-257-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSA ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.