MSA ALLIANCE, LLC (NPI# 1689988057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689988057 |
| Entity Type | Organization |
| Organization Name | MSA ALLIANCE, LLC |
| Practice Address |
4550 Memorial Dr Ste 280 Belleville IL 62226-5372 |
| Mailing Address |
4500 Memorial Dr Medical Affairs Credentialing Department Belleville IL 62226-5360 |
| Practice Telephone | 6182773109 |
| Practice Fax Number | 6182773143 |
| Mailing Telephone | 6182574644 |
| Mailing Fax Number | 6182576946 |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2013-02-25 |
| Authorized Official Name | JAMES B. DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6182574644 |
| Is Organization Subpart | Y |
| Parent Organization Name | MSA ALLIANCE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518369438 | Msa Alliance, LLC | Psychiatry & Neurology | 4550 Memorial Dr Ste 340, Suite 340, Belleville, IL 62226-5372 | 2014-09-23 |
| 1760819676 | Msa Alliance, LLC | Family Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2013-10-09 |
| 1366781171 | Msa Alliance, LLC | Internal Medicine | 624 Vons-jost, Waterloo, IL 62298-1592 | 2013-02-14 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1972020279 | Msa Alliance, LLC | Surgery | 1414 Cross St Ste 210, Shiloh, IL 62269-2988 | 2017-08-28 |
| 1134642531 | Msa Alliance, LLC | Internal Medicine | 1414 Cross St Ste 210, Shiloh, IL 62269-2988 | 2017-07-18 |
| 1093258154 | Msa Alliance, LLC | Surgery | 2 Memorial Dr, Suite 201, Alton, IL 62002-6723 | 2016-11-22 |
| 1801339965 | Msa Alliance, LLC | Surgery | 2016 Vadalabene Dr, Suite B, Maryville, IL 62062-6901 | 2016-11-22 |
| 1760939060 | Msa Alliance, LLC | Internal Medicine | 1404 Cross St, Suite 2114, Shiloh, IL 62269-2988 | 2016-09-02 |
| 1053711895 | Msa Alliance, LLC | Surgery | 2133 Vadalabene Dr, Suite 2, Maryville, IL 62062-5839 | 2014-08-29 |
| Street Address |
4550 MEMORIAL DR STE 280 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427055961 | Lawrence Mcclinton | Physician Assistant | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226-5372 | 2005-06-30 |
| 1902273717 | Tammi Lynn Jones | Nurse Practitioner | 4550 Memorial Dr, Suite 360, Belleville, IL 62226-5372 | 2015-08-27 |
| 1235474057 | Memorial Medical Group, LLC | Anesthesiology | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-12-05 |
| 1013265248 | Deanna L. Rodenberg | Registered Nurse | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-08-20 |
| 1699061259 | Oa Associated LLC | Specialist/Technologist | 4550 Memorial Dr, Moc-1, Suite G-100, Belleville, IL 62226-5372 | 2011-06-22 |
| 1619260932 | Dori Hunt | Nurse Practitioner | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2011-05-19 |
| 1821302118 | Pc Associates, LLC | Hospitalist | 4550 Memorial Dr, Suite 340, Belleville, IL 62226-5372 | 2010-07-29 |
| 1386958668 | Pc Associates, LLC | Family Medicine | 4550 Memorial Dr, Ste 180, Belleville, IL 62226-5372 | 2010-07-29 |
| 1376857656 | Ca Group, LLC | Internal Medicine | 4550 Memorial Dr, Ste 310, Belleville, IL 62226-5372 | 2010-07-29 |
| 1649584921 | Ca Group LLC | Internal Medicine | 4550 Memorial Dr, Suite 320, Belleville, IL 62226-5372 | 2010-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952720369 | Michael Benson | Urology | 36 Newark Ave Ste 200, Belleville, NJ 07109-4121 | 2014-04-14 |
| 1124229901 | Beneranda Sophia Ford-glanton | Urology | 301 W Lincoln St Ste 201, Belleville, IL 62220-1901 | 2007-05-30 |
| 1629167986 | Urological Associates of Belleville Il Ltd | Urology | 301 W Lincoln St Ste 57, Belleville, IL 62220-1901 | 2006-10-12 |
| 1083633283 | Erol Ulker | Urology | 36 Newark Avenue, Suite 200 Urology Consultants Pa, Belleville, NJ 07109-4121 | 2006-07-19 |
| 1295049666 | Msa Alliance, LLC | Urology | 4550 Memorial Dr, Ste 350, Belleville, IL 62226-5372 | 2010-07-28 |
| 1801042700 | James Patrick Rybak | Urology | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226-5372 | 2008-08-11 |
| 1700973674 | Michael Gerard Guignon Sr. | Urology | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226 | 2006-10-10 |
| 1548352115 | David Joseph Ray | Urology | 2420 G St, Belleville, KS 66935-2400 | 2006-09-29 |
| 1609982099 | Urology Consultants Pa | Urology | 36 Newark Avenue, Suite 200, Belleville, NJ 07109-4121 | 2006-08-21 |
| 1649294034 | Michael P Ciccone | Urology | 36 Newark Ave, Suite 200 Urology Consultants Pa, Belleville, NJ 07109-4121 | 2006-07-27 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.