NPIMap

Organization Active NPI

Msa Alliance, LLC

  • Interventional Pain Medicine Physician
  • Belleville, IL
National Provider Identifier
1821307554
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
MSA ALLIANCE, LLC
Practice address
4700 Memorial Drive
Ste. 230
Belleville, IL 62226
Phone
(618) 257-5902
Fax
(618) 257-6671
NPI assigned
Sep 29, 2010
Organization subpart
Yes
Parent organization
MSA ALLIANCE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

4700 Memorial Drive
Ste. 230
Belleville, IL 62226

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
Msa Alliance LLC45 organizations share this tax ID, including this one
Part of
Msa Alliance LLC

Other organizations with this tax ID 44

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

View all 44

Locations

4700 Memorial Dr
Ste 230
Belleville, IL 62226
Phone (618) 212-4414

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1821307554",
    "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": "4700 MEMORIAL DRIVE",
            "address_2": "STE. 230",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-5902",
            "fax_number": "618-257-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSA ALLIANCE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MSA ALLIANCE, LLC",
        "enumeration_date": "2010-09-29",
        "last_updated": "2013-03-06",
        "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": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.