NPIMap

Organization Active NPI

Collins Ambulatory Anesthesia Services SC

  • Anesthesiology Physician
  • Edwardsville, IL
National Provider Identifier
1992003636
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036079652 Issued in IL
Legal business name
COLLINS AMBULATORY ANESTHESIA SERVICES SC
Practice address
106 Friars LN
Edwardsville, IL 62025-3876
Phone
(618) 973-5189
NPI assigned
Mar 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Dr. Gregory Collins, M.D.
Title
President
Phone
(618) 973-5189

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 036079652 IL Primary

Addresses

Primary practice location

106 Friars LN
Edwardsville, IL 62025-3876

Mailing address

106 Friars LN
Edwardsville, IL 62025-3876
Phone (618) 973-5189

Other identifiers 1

IdentifierTypeStateIssuer
1770804452MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1992003636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FRIARS LN",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253876",
            "telephone_number": "618-973-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FRIARS LN",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253876",
            "telephone_number": "618-973-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINS AMBULATORY ANESTHESIA SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-973-5189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036079652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770804452",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.