FAIRVIEW HEIGHTS MEDICAL GROUP SC (NPI# 1679503668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679503668 |
Entity Type | Organization |
Organization Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
Practice Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
Mailing Address |
670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 |
Practice Telephone | 3149967644 |
Practice Fax Number | 3149967658 |
Mailing Telephone | 3149967644 |
Mailing Fax Number | 3149967658 |
Enumeration Date | 2006-07-04 |
Last Update Date | 2020-07-16 |
Authorized Official Name | KAREN CANTER-KOESTER (VP OPERATIONS AND STRATEGY) |
Authorized Official Telephone | 3149967610 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 500720107 | 05 |
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 |
670 MASON RIDGE CENTER DR SUITE 300 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63141-8573 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285664268 | Physician Groups Lc | Clinic/Center | 670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573 | 2006-07-04 |
1811392210 | Fairview Heights Medical Group, Sc | Internal Medicine | 670 Mason Ridge Center Dr, Ste 300, Saint Louis, MO 63141-8573 | 2014-10-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
Find all providers in zip 63141 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
1174830640 | Washington University School of Medicine | Clinic/Center | 4921 Parkview Pl Lowr Level, Center for Advanced Medicine, Saint Louis, MO 63110-1032 | 2010-09-07 |
1013542877 | Washington University | Clinic/Center | 4921 Parkview Pl Ste 5a, Saint Louis, MO 63110-1032 | 2020-03-11 |
1760946156 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2019-01-30 |
1003387689 | Victus Physician Services, LLC | Clinic/Center | 12345 West Bend Drive, Suite 201, Saint Louis, MO 63128 | 2018-12-08 |
1356822993 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2018-08-22 |
1972091825 | Wuca Southwest Pediatrics LLC | Clinic/Center | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2018-04-26 |
1669995403 | Washington University | Clinic/Center | 11125 Dunn Rd Ste 100, Saint Louis, MO 63136-6132 | 2017-07-24 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63141 |
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.