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Black River Ambulatory Surgery Center, LLC

Ambulatory Surgical Clinic/Center in Poplar Bluff, MO · enumerated 2019 · authorized official David Prather, Chief Financial Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1770149304

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Registry record

Entity type Organization (Type 2)
Legal business name Black River Ambulatory Surgery Center, LLC
Practice address 219 Physicians Park, Poplar Bluff, MO, 63901
Phone (573) 609-2444
Enumeration date May 20, 2019
Last updated in NPPES May 20, 2019

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities Primary
261QM1300X Multi-Specialty Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name David Prather
Title Chief Financial Officer
Phone (573) 331-5129

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Black River Ambulatory Surgery Center, LLC?
Black River Ambulatory Surgery Center, LLC is registered in NPPES as a Ambulatory Surgical Clinic/Center (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-05-20.