Fairview Heights Medical Group SC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FAIRVIEW HEIGHTS MEDICAL GROUP SC

Doing business as

Human Motion Institute

Practice address

1 Memorial Dr
Suite G204
Alton, IL 62002-6722

Phone

(618) 465-7887

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Raymond P Davidson II, MD

Title

President

Phone

(314) 286-2028

Specialties & licenses 1

Addresses

Other names 1

• Human Motion Institute Doing business as

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1093858276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-996-7644",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "address_2": "SUITE G204",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-465-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEIGHTS MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-286-2028",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Human Motion Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evergreen Glenhaven Operations, LLC
• Kaycee Eyers, FNP
• Christina Faccin, D.C.
• Amy Elizabeth Fahnestock
• Fairview Heights Medical Group SC (Family Physicians Of Alton)
• Fairview Heights Medical Group SC (Alton Internal Medicine)
• Fairview Heights Medical Group SC (Family Physicians of Alton)
• Fairview Heights Medical Group SC (Alton Surgery)
• Fairview Heights Medical Group SC (Alton Urological Associates)
• Fairview Heights Medical Group SC (AMH Hospitalists)

• Physical Therapy Clinic/Center in Alton, IL
• Providers in Alton, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.