Associated Physicians Group, LTD

Key facts

NPI

1811940893

Entity type

Organization (NPI type 2)

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X

License

042007668 (IL)

Legal business name

ASSOCIATED PHYSICIANS GROUP, LTD

Practice address

916 Talon Dr
Suite 102
O Fallon, IL 62269-1848

Phone

(618) 628-8211

Fax

(618) 682-0883

NPI assigned

May 18, 2006

Organization subpart

No

Authorized official

Name

Ms. Renee L Carson

Title

Billing Supervisor

Phone

(618) 628-8211

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Associated Physicians Group LTD Physical Therapist · Creve Couer, MO · NPI 1902157225
  Same enrollment O20121031000487

Practitioners 9

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

• Shannon Deann Dobsch, FNP Family Nurse Practitioner · Washington, MO · NPI 1821634247
  NPD
• Edward Carl Anderson, PA Physician Assistant · Granite City, IL · NPI 1326104910
  NPD (past)
• Amanda Michelle Connoyer, APRN Family Nurse Practitioner · Worden, IL · NPI 1114260551
  NPD (past)
• Candyce Frey Nurse Practitioner · Glen Carbon, IL · NPI 1881494086
  NPD (past)
• Scott F Morrison, MD Family Medicine Physician · O Fallon, IL · NPI 1508858713
  NPD (past)
• Jannell W Vetter, PT Physical Therapist · Freeburg, IL · NPI 1982600375
  NPD (past)
• Nathan G Wilson, LPT Physical Medicine & Rehabilitation Physician · East Alton, IL · NPI 1427230663
  NPD (past)
• Angela D Wuebbels, PT Physical Therapist · Swansea, IL · NPI 1912903394
  NPD (past)
• Ryan Edwin Lueking, PA Medical Physician Assistant · Saint Louis, MO · NPI 1518352772
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Medicare enrollment records

National Provider Directory

Locations

Interoperability endpoints

• Direct secure messaging: hsadeghipour@apg.direct.talkehr.com
• Direct secure messaging: jzimmerman@apg.direct.talkehr.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2010.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1811940893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-682-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-682-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED PHYSICIANS GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "618-628-8211",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IL",
            "license": "042007668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL GROUP NUMBER",
            "identifier": "08220357",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in O Fallon, IL · Pain Medicine (Physical Medicine & Rehabilitation) Physician in Illinois