FAIRVIEW HEIGHTS MEDICAL GROUP SC (NPI# 1164553483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164553483 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| Other Organization Name | ALTON INTERNAL MEDICINE |
| Practice Address |
2 Memorial Dr Suite 220 Alton IL 62002-6723 |
| Mailing Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 6184623191 |
| Mailing Telephone | 3149967644 |
| Mailing Fax Number | 3149967658 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-01-04 |
| Authorized Official Name | RAYMOND P DAVIDSON II (PRESIDENT) |
| Authorized Official Telephone | 3142862028 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Alton Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1538341094 | Fairview Heights Medical Group Sc | Urology | 2246 S State Route 157, Ste. 200, Glen Carbon, IL 62034-1717 | 2007-11-27 |
| 1487787818 | Fairview Heights Medical Group Sc | Pediatrics | 11th and Broadway, 4th Floor, Quincy, IL 62301 | 2007-03-14 |
| 1326171158 | Fairview Heights Medical Group Sc | Pediatrics | 4230 Lincolnshire Dr Ste A, Mount Vernon, IL 62864-2189 | 2007-03-13 |
| 1710168166 | Fairview Heights Medical Group Sc | Hospitalist | 1 Memorial Dr, Suite 2-101, Alton, IL 62002-6722 | 2007-11-14 |
| 1417140609 | Fairview Heights Medical Group Sc | Urology | 8 Sunset Hills Professional Ctr, Edwardsville, IL 62025-3760 | 2007-08-22 |
| 1487847638 | Fairview Heights Medical Group Sc | Urology | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2007-08-21 |
| 1114110350 | Fairview Heights Medical Group Sc | Internal Medicine | 400 N Caldwell St, Staunton, IL 62088-1423 | 2007-08-21 |
| 1538292370 | Fairview Heights Medical Group Sc | Pediatrics | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-03-13 |
| 1528199718 | Fairview Heights Medical Group Sc | Family Medicine | 230 Regional Dr, Alton, IL 62002-5942 | 2007-03-08 |
| Street Address |
2 MEMORIAL DR SUITE 220 |
| City | ALTON |
| State | IL |
| Zip Code | 62002-6723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619963063 | Ahmad A Karadaghy | Internal Medicine | 2 Memorial Dr, Suite 202, Alton, IL 62002-6723 | 2005-09-21 |
| 1518437672 | Kelsey Marie Browne | Nurse Practitioner | 2 Memorial Dr, Suite 205, Alton, IL 62002-6723 | 2018-12-03 |
| 1093258154 | Msa Alliance, LLC | Surgery | 2 Memorial Dr, Suite 201, Alton, IL 62002-6723 | 2016-11-22 |
| 1083067250 | Arjun Sivaraman | Surgery | 2 Memorial Dr, Ste 205, Alton, IL 62002-6723 | 2016-07-22 |
| 1437523677 | Krista Ludwig | Nurse Practitioner | 2 Memorial Dr, Suite 202, Alton, IL 62002-6723 | 2015-11-28 |
| 1518337815 | Gastroenterology Medical Consultants, P.C. | Specialist | 2 Memorial Dr, Suite 202, Alton, IL 62002-6723 | 2015-09-29 |
| 1700275120 | Megan Bagheri | Nurse Practitioner | 2 Memorial Dr, Ste. 220, Alton, IL 62002-6723 | 2015-01-22 |
| 1487971537 | Lorraine Rosenthal Seiffert | Nurse Practitioner | 2 Memorial Dr, Ste 101, Alton, IL 62002-6723 | 2010-04-29 |
| 1477882454 | Christine Meredith Harlan | Registered Nurse | 2 Memorial Dr, Suite 220, Alton, IL 62002-6723 | 2009-12-21 |
| 1750547352 | Donald William Buck II | Plastic Surgery | 2 Memorial Dr, Ste 101, Alton, IL 62002-6723 | 2008-08-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194811430 | Joanna E. Janas-kaminsky | Internal Medicine | #2 Saint Anthony's Way, Suite 205, Alton, IL 62002-4569 | 2006-10-05 |
| 1972610921 | Robert Steven Edwards | Internal Medicine | 4434 Friarwood Dr, Alton, IL 62002-6925 | 2006-08-24 |
| 1760455661 | D'andrienne C. Jones | Internal Medicine | 2416 Bloomer Drive, Alton, IL 62002 | 2006-02-10 |
| 1174504682 | Mary Colette Schmidt | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2005-11-10 |
| 1275525271 | Tariq L Quadri | Internal Medicine | 1 Professional Dr, Suite 220, Alton, IL 62002-5068 | 2005-08-17 |
| 1174151112 | Cep America - Illinois Snf, LLP | Internal Medicine | 3523 Wickenhauser Ave, Alton, IL 62002-2118 | 2020-03-27 |
| 1295247534 | Cep America - Illinois Snf, LLP | Internal Medicine | 3490 Humbert Rd, Alton, IL 62002-7101 | 2017-10-26 |
| 1841710712 | Jodi Keiko Pecka Yanagida | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2017-06-22 |
| 1265960058 | Chandni Sinha | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2017-05-24 |
| 1164973947 | Cep America - Illinois Hospitalist, LLP | Internal Medicine | 1 Saint Anthonys Way, Alton, IL 62002-4568 | 2016-10-17 |
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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.