David L Priebe, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

66430 Issued in WI

Practice address

3986 Maryville Rd
Granite City, IL 62040-4191

Phone

(618) 797-0618

Fax

(618) 797-2243

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multi-Care Specialists SC

  • Family Medicine Physician
  • Granite City, IL
  • NPI 1811087604
  Medicare reassignment NPD
• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment NPD
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD
• Great Plains Surgery PC

  • Surgery Physician
  • Holdrege, NE
  • NPI 1962473835
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1194769166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3986 MARYVILLE RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404191",
            "telephone_number": "618-797-0618",
            "fax_number": "618-797-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3986 MARYVILLE RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404191",
            "telephone_number": "618-797-0618",
            "fax_number": "618-797-2243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Leota St Ste 100",
            "address_purpose": "LOCATION",
            "city": "North Platte",
            "state": "NE",
            "postal_code": "691016578",
            "country_code": "US",
            "telephone_number": "308-534-4440",
            "fax_number": "308-534-7675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W231N1440 Corporate Ct",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "53186",
            "country_code": "US",
            "telephone_number": "262-896-6000",
            "fax_number": "308-534-7675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIEBE",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-04-18",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "66430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47081633613",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physical Medicine Clinic of Granite City LTD
• Victor Manuel Pinones, D.M.D
• Adriana Poenitzsch, RPH
• Heather Roan Porter, PTA
• Donna Kay Porterfield, D.M.D.
• Professional Radiologic Imaging LTD
• Project Ceap PLLC
• Pulmonary Diagnostic & Therapeutic Services PC
• Danielle Aliss Rahman, PHARMD
• Kelsey Rahmoeller, DC

• Sports Medicine (Family Medicine) Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.