Buffalo Prairie Nursing and Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BUFFALO PRAIRIE NURSING AND REHAB LLC

Doing business as

Buffalo Prairie Center for Rehab and Healthcare

Practice address

631 W Main St
Buffalo, MO 65622-7496

Phone

(417) 345-5422

NPI assigned

Oct 12, 2021

Last updated

Oct 12, 2021By 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

Bernard David Perlow

Title

Authorized Official

Phone

(443) 928-3278

Specialties & licenses 1

Addresses

Other names 1

• Buffalo Prairie Center for Rehab and Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013679596. Details of each certification follow.

• CCN 265471 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265471

Legal name

BUFFALO PRAIRIE NURSING AND REHAB LLC

Doing business as

BUFFALO PRAIRIE CENTER FOR REHAB AND HEALTHCARE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 21, 1991

Last certification

Oct 7, 2024

Beds

60

Ownership / control type

Limited Liability Corporation

Multi-facility organization

PRIME MANAGEMENT

Most recent change of ownership

Aug 31, 2021

Organization structure

LLCProprietary

Incorporated

Dec 17, 2020 in MO

Enrollment address

631 W Main St
Buffalo, MO 65622-7496

Nursing home name

BUFFALO PRAIRIE CENTER FOR REHAB AND HEALTHCARE

Affiliated entity

BLUE SKY BASIN, LLC

Listed as

Buffalo Prairie Center for Rehab and HealthcareCCN 265471 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Oct 21, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6041.3 residents per day on average

Chain

Blue Sky Basin, LLC5 facilities in the chain

Special focus status

SFF Candidate

Penalties (3 years)

3Fines totaling $92,080

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Country Aire Healthcare LLC

  dba Country Aire Retirement Center

  • Skilled Nursing Facility
  • Lewistown, MO
  • NPI 1619639192

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Georgian Gardens Healthcare LLC

  dba Georgian Gardens Center for Rehab and Healthcare

  • Skilled Nursing Facility
  • Potosi, MO
  • NPI 1972265452

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Golden Years Nursing and Rehab LLC

  dba Golden Years Center for Rehab and Healthcare

  • Skilled Nursing Facility
  • Harrisonville, MO
  • NPI 1063174548

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Independence Healthcare LLC

  dba Abode Health and Wellness Center

  • Skilled Nursing Facility
  • Independence, MO
  • NPI 1790658086

  Blue Sky Basin LLC

  CMS ownership
• Nodaway Healthcare LLC

  dba Nodaway Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Maryville, MO
  • NPI 1497453344

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Oregon Healthcare LLC

  dba Oregon Care Center

  • Nursing Facility/Intermediate Care Facility
  • Oregon, MO
  • NPI 1043918998

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Pleasant View Healthcare LLC

  dba Pleasant View

  • Nursing Facility/Intermediate Care Facility
  • Rock Port, MO
  • NPI 1699473546

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership

Practitioners 4

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.

• Fernando Cavero, M.D.

  • Internal Medicine Physician
  • Sparta, MO
  • NPI 1669545711
  NPD (past)
• George W Mathews, DO

  • Family Medicine Physician
  • Humansville, MO
  • NPI 1619980919
  NPD (past)
• Gordon Reed Wouters, DO

  • Family Medicine Physician
  • Hermitage, MO
  • NPI 1851402010
  NPD (past)
• Simon Fensterszaub, D.O.

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1003077322
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Fernando Cavero, M.D.

  • Internal Medicine Physician
  • Sparta, MO
  • NPI 1669545711

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1013679596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ROCKAWAY TPKE STE 6",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 W MAIN ST",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656227496",
            "telephone_number": "417-345-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO PRAIRIE NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "PERLOW",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "443-928-3278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buffalo Prairie Center for Rehab and Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Dyer Booth, DDS
• Brandi F Bowden, MS, LPC
• Kurt Russell Bravata, M.D.
• Bristol Care,Inc.
• Buffalo Prairie Dental
• Buffalo Prairie Opco, LLC (Buffalo Prairie Center for Rehab and Healthcare)
• Buffalo Prairie Operations Management LLC
• Buffalo Professional Pharmacy Inc (Corner Drug Store)
• Buffalo SNF Operations, LLC (Buffalo Prairie Center for Rehab and Healthcare)
• Scott M Burks, O,D,

• Skilled Nursing Facility in Buffalo, MO
• Providers in Buffalo, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.