McPeak Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300060 Issued in KY

Legal business name

MCPEAK SURGERY CENTER LLC

Practice address

108 Bravo Blvd
Glasgow, KY 42141-3478

Phone

(270) 651-2181

Fax

(270) 651-2183

NPI assigned

Oct 25, 2005

Last updated

May 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Spencer Witcher, MDNPI 1700876455

Title

Owner

Phone

(270) 651-2181

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

McPeak Surgery Center LLCCCN 18C0001010

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Clarkson Optometry Inc

  dba Clarkson Eyecare

  • Optometrist
  • Saint Louis, MO
  • NPI 1790026540

  Member Of

  NPD member

Practitioners 2

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.

• Spencer Broady Witcher, MD

  • Ophthalmology Physician
  • Glasgow, KY
  • NPI 1700876455
  Authorized official Same address or phone
• Mark A Kroll, MD

  • Ophthalmology Physician
  • Bowling Green, KY
  • NPI 1568494136
  NPD

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1881684538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BRAVO BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413478",
            "telephone_number": "270-651-2181",
            "fax_number": "270-651-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BRAVO BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413478",
            "telephone_number": "270-651-2181",
            "fax_number": "270-651-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCPEAK SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "WITCHER",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-651-2181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36000826",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Alesha Maynard, CSW
• Debra K. McCandless
• Carol McCarthy, CSW
• Cathy Lynn McCoy
• Dustin Roy McKinney, PHARMD
• McPeak Vision Partners PLLC
• McPeak Vision Partners PLLC
• Dailey McPeak, MD
• Cindy Meadows, LPCC
• Medical Arts Pharmacy of Glasgow, Inc. (Medical Arts Pharmacy)

• Ambulatory Surgical Clinic/Center in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.