FAIRVIEW HEIGHTS MEDICAL GROUP SC (NPI# 1942344981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942344981 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| Other Organization Name | ALTON WOUND CARE CENTER |
| Practice Address |
1 Memorial Dr 1st Floor Alton IL 62002-6722 |
| Mailing Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 6184337066 |
| Mailing Telephone | 3149967644 |
| Mailing Fax Number | 3149967658 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2008-01-07 |
| 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 | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Alton Wound Care Center | 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 |
1 MEMORIAL DR 1ST FLOOR |
| City | ALTON |
| State | IL |
| Zip Code | 62002-6722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174504682 | Mary Colette Schmidt | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2005-11-10 |
| 1093323131 | Alton Memorial Hospital | Clinical Medical Laboratory | 1 Memorial Dr, Alton, IL 62002-6722 | 2020-07-15 |
| 1295358810 | Andrew James Standefer | Registered Nurse | 1 Memorial Dr, Alton, IL 62002-6722 | 2020-05-19 |
| 1356988273 | Clair Laurent Visconti | Physician Assistant | 1 Memorial Dr, Alton, IL 62002-6722 | 2019-12-10 |
| 1932682101 | Hannah Josephine Mallets | Occupational Therapist | 1 Memorial Dr, Alton, IL 62002-6722 | 2018-09-12 |
| 1154826501 | Aaron D Wede | Nurse Anesthetist, Certified Registered | 1 Memorial Dr, Alton, IL 62002 | 2018-03-28 |
| 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 |
| 1033657929 | Meredith Anne Parker | Social Worker | 1 Memorial Dr, 2nd Floor, Olin Wing, Alton, IL 62002-6722 | 2017-02-10 |
| 1942758081 | Brennan Malham | Physician Assistant | 1 Memorial Dr, Alton, IL 62002-6722 | 2016-09-19 |
| Find all providers in the same location | ||||
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447351028 | Instaclinic of Illinois, LLC | Clinic/Center | 2811 Homer Adams Parkway, Alton, IL 62002 | 2006-09-26 |
| 1366050007 | Generation Clinical Partners LLC | Clinic/Center | 1251 College Ave, Alton, IL 62002-6735 | 2020-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FAIRVIEW HEIGHTS MEDICAL GROUP SC.
| 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.