Prairie Home Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PRAIRIE HOME HOSPICE, INC.

Practice address

1108 E College Dr
Marshall, MN 56258-1902

Phone

(507) 337-0080

Fax

(507) 337-0081

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Sarah Kirchner

Title

Ceo

Phone

(507) 337-0080

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Hospice certification: CCN 241507

Legal name

PRAIRIE HOME HOSPICE, INC.

Doing business as

PRAIRIE HOME COMMUNITY CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 2, 1986

Last certification

Jan 10, 2019

Ownership / control type

Other

Organization structure

CorporationNon-profit

Incorporated

Jul 10, 1984 in MN

Enrollment address

1108 E College Dr
Marshall, MN 56258-1902

Listed as

Prairie Home HospiceCCN 241507

Ownership

Non-Profit

Certified

May 2, 1986

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Timothy P Michals Jr., M.D.

  • Internal Medicine Physician
  • Marshall, MN
  • NPI 1164620464

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Timothy P Michals Jr., M.D.

  • Internal Medicine Physician
  • Marshall, MN
  • NPI 1164620464

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1255424818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E COLLEGE DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581902",
            "telephone_number": "507-337-0080",
            "fax_number": "507-337-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E COLLEGE DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581902",
            "telephone_number": "507-337-0080",
            "fax_number": "507-337-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE HOME HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "KIRCHNER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-337-0080"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434555000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE HOSPICE",
            "identifier": "3Z13PR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "652691800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrik Scott Pinckney, D.C.
• Betsy Plotz, RD
• Kaycee Polite, LCSW
• Jason Michael Polzin, DPT
• Prairie Community Services Inc
• Prairie Winds Counseling
• Preferred Health of Marshall, PA
• Paul Joseph Puetz, DC
• Robert Thomas Quasius Sr.
• Omer Qureishy, MBBS.MD

• Community Based Hospice Care Agency in Marshall, MN
• Providers in Marshall, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.