Prairie Assisted Living Services LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRAIRIE ASSISTED LIVING SERVICES LLC

Practice address

4914 Amberglow Dr
Bismarck, ND 58503-8851

Phone

(701) 226-9804

Fax

(701) 751-1307

NPI assigned

Apr 5, 2012

Organization subpart

No

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

Authorized official

Name

Tisha Scheuer, NP-CNPI 1093292815

Title

Owner

Phone

(701) 226-9804

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tisha Scheuer, FNP-C

  • Family Nurse Practitioner
  • Bismarck, ND
  • NPI 1093292815
  Medicare reassignment NPD Authorized official
• Janice K Hogue Kinahan, NP

  • Nurse Practitioner
  • Kennesaw, GA
  • NPI 1760559512
  NPD (past)

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1033475868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 AMBERGLOW DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038851",
            "telephone_number": "701-226-9804",
            "fax_number": "701-751-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 AMBERGLOW DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038851",
            "telephone_number": "701-226-9804",
            "fax_number": "701-751-1307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7938 Stratford Ln",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303504159",
            "country_code": "US",
            "telephone_number": "770-804-9479",
            "fax_number": "770-396-7942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRAIRIE ASSISTED LIVING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "SCHEUER",
        "authorized_official_first_name": "TISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-226-9804",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Porter, LRD
• Theresa Ann Porter, LICSW
• Amanda Portra, M.S., CCC-SLP
• Monika Pothamsetti, MD
• Massa Poure
• Prairie Point Counseling PLLC
• Prairie Rose Family Dentists
• Prairie Rose Family Dentists
• Prairie Sea Hearing Center LLC
• Prairie Sinus Ear & Allergy PC

• Primary Care Clinic/Center in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Primary Care Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.