NPIMap

Organization Active NPI

Fairview Heights Medical Group SC

  • Cardiovascular Disease Physician
  • Florissant, MO
National Provider Identifier
1821131806
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FAIRVIEW HEIGHTS MEDICAL GROUP SC
Practice address
201 Dunn Rd
Florissant, MO 63031-7928
Phone
(314) 837-3784
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

201 Dunn Rd
Florissant, MO 63031-7928

Mailing address

670 Mason Ridge Center Dr
Suite 300
Saint Louis, MO 63141-8573
Phone (314) 996-7644

Other names 1

  • The Heart Care Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairview Heights Med GR23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

201 Dunn Rd
Florissant, MO 63031
Phone (314) 830-3841

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1821131806",
    "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": "201 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317928",
            "telephone_number": "314-837-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEIGHTS MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-01-04",
        "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": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Heart Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.