Prairie Medicine LTD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PRAIRIE MEDICINE LTD

Practice address

421 S Beaumont Rd
Prairie Du Chien, WI 53821-1905

Phone

(608) 326-6402

Fax

(608) 326-6404

NPI assigned

Dec 23, 2005

Last updated

Oct 16, 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

Mrs. Brenda J Jones

Title

Office Manager

Phone

(608) 326-6402

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1063499739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S BEAUMONT RD",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538211905",
            "telephone_number": "608-326-6402",
            "fax_number": "608-326-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S BEAUMONT RD",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538211905",
            "telephone_number": "608-326-6402",
            "fax_number": "608-326-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "608-326-6402",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30071400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0944967",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prairie Du Chien Memorial Hospital Association, Inc.
• Prairie Du Chien Memorial Hospital Association, Inc. (Crossing Rivers Health Hospice)
• Prairie Du Chien Rescue Squad Inc
• Prairie Health LLC
• Prairie Medical LLC
• Prairie Nursing Facility LLC (Prairie Maison)
• Bernard S Pratte, D.D.S.
• Maranda Record, M.D.
• Nathan B Rickertsen, OTR
• Riverside Chiropractic & Wellness Center LLC

• Surgery Physician in Prairie Du Chien, WI
• Providers in Prairie Du Chien, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.