FAIRVIEW HEIGHTS MEDICAL GROUP SC
NPI 1073022000
Clinic/Center - Multi-Specialty in Saint Louis, MO

NPI Status: Active since September 21, 2017

Contact Information

660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 996-7644
Fax: (314) 996-7658

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  • Organization
  • Clinic/Center
  • Multi-Specialty

About FAIRVIEW HEIGHTS MEDICAL GROUP SC

This page provides the complete NPI Profile along with additional information for Fairview Heights Medical Group Sc, a provider established in Saint Louis, Missouri operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1073022000 assigned on September 2017. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is John T Ellena Md (Medical Director)

NPI
1073022000
Provider Legal Name
FAIRVIEW HEIGHTS MEDICAL GROUP SC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
660 MASON RIDGE CENTER DR STE 300 SAINT LOUIS, MO 63141
Location Phone
(314) 996-7644
Location Fax
(314) 996-7658
Mailing Address
660 MASON RIDGE CENTER DR STE 300 SAINT LOUIS, MO 63141
Mailing Phone
(314) 996-7663
Mailing Fax
(314) 996-7658
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-21-2017
Last Update Date
09-03-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM2500XAmbulatory Health Care Facilities

Clinic/Center
Medical Specialty

 
2261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN T ELLENA MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(314) 996-7644

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073022000, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 40. The final step is to find the difference between that total and the next multiple of ten (40 - 40 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 0 → 0 2 → 4 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 0 + 2 + 4 + 0 + 0 + 24 = 40

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 40 is 40. The difference is the calculated check digit.

40 - 40 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1073022000.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Nurse Practitioner (Acute Care)
660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 63141

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073022000, enumerated as an "organization" on September 21, 2017.

The provider is located at 660 MASON RIDGE CENTER DR STE 300 SAINT LOUIS, MO 63141 and the phone number is (314) 996-7644.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.