Prairie Surgicare, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PRAIRIE SURGICARE, LLC

Practice address

7620 N University St
Suite 101
Peoria, IL 61614-8300

Phone

(309) 691-7774

Fax

(309) 689-5768

NPI assigned

May 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richard Kube II, MD, FACSSNPI 1386625374

Title

Owner/Medical Director

Phone

(309) 691-7774

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard A Kube II, MD

  • Specialist
  • Peoria, IL
  • NPI 1386625374
  Authorized official Same address or phone

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1336408038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY ST",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148300",
            "telephone_number": "309-691-7774",
            "fax_number": "309-689-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 N UNIVERSITY ST",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148300",
            "telephone_number": "309-691-7774",
            "fax_number": "309-689-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE SURGICARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "KUBE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-691-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD, FACSS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Gerald Potempa, MS, LMFT
• Shirley Potts
• Kayla Powell, NCC
• Divyang Pradhan, MBBS
• Prairie Spine and Pain Institute SC
• Prairieland Counseling
• Matthew Michael Preston, M.D.
• Chiara Pretto
• Ashley Lynne Pribble, DNP
• Caitlin Marie Pribble

• Ambulatory Surgical Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.