Prairie State Anesthesia Associates, PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

PRAIRIE STATE ANESTHESIA ASSOCIATES, PLLC

Practice address

5023 N Illinois St
Fairview Heights, IL 62208-3453

Phone

(618) 239-0678

NPI assigned

Aug 21, 2020

Organization subpart

No

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

Authorized official

Name

Melanie Smith

Title

Enrollment

Phone

(425) 803-3885

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1487266391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 PEACHTREE RD NE STE 340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261137",
            "telephone_number": "425-803-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5023 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083453",
            "telephone_number": "618-239-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE STATE ANESTHESIA ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "ENROLLMENT",
        "authorized_official_telephone_number": "425-803-3885"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Planned Parenthood Great Rivers-Illinois
• Planned Parenthood of the St. Louis Region and Southwest Missouri
• Pontiac-WM Holliday SD 105
• Kristine Potter, SLP
• Emily K Powers, PHARM. D.
• Preferred Behavioral Health Mso, Inc. (Preferred Behavioral Health)
• James Price
• Amberlee Nicole Pritchard, DC
• Promed Preferred Il 2 PLLC (Preferred Behavioral Health Group)
• Prorehab, PC (Athletico Physical Therapy)

• Certified Registered Nurse Anesthetist in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.