Prairie Surgical Associates P C

Primary specialty

SpecialistTaxonomy code 174400000X

License

21192 Issued in NE

Legal business name

PRAIRIE SURGICAL ASSOCIATES P C

Practice address

1919 S 40TH St
Suite 107
Lincoln, NE 68506-5258

Phone

(402) 486-3400

Fax

(402) 486-3344

NPI assigned

Sep 10, 2007

Last updated

Sep 10, 2007By 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. Kevin R Mota, M.D.NPI 1144288028

Title

President

Phone

(402) 486-3400

Specialties & licenses 1

Addresses

Locations

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.

• Kevin R Mota, M.D.

  • Surgery Physician
  • Lincoln, NE
  • NPI 1144288028
  Authorized official Same address or phone
• John L Reed, MD

  • Surgery Physician
  • Lincoln, NE
  • NPI 1306947981
  NPD (past)

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1962697300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "SUITE 107",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-486-3400",
            "fax_number": "402-486-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "SUITE 107",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065258",
            "telephone_number": "402-486-3400",
            "fax_number": "402-486-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE SURGICAL ASSOCIATES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "MOTA",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-486-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NE",
            "license": "21192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prairie Health Ventures LLC
• Prairie Orthopaedic & Plastic Surgery, P.C.
• Prairie Orthopaedic & Plastic Surgery, P.C.
• Prairie Orthopaedic & Plastic Surgery, PC
• Prairie Psychiatric LLC
• Prairie Wellness Collective, LLC
• Rachelle Lynn Prall
• Shelbi Prange
• Evie Praska
• Jackuelyn M Prater, MSW LMHP LCSW

• Specialist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Specialist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.