NPIMap

Organization Active NPI

Prairie View Healthcare, Inc.

Doing business as Excell Hospice

  • Community Based Hospice Care Agency
  • Oklahoma City, OK
National Provider Identifier
1255858379
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRAIRIE VIEW HEALTHCARE, INC.
Doing business as
Excell Hospice
Practice address
1200 SW 104TH St Ste D
Oklahoma City, OK 73139
Phone
(405) 631-0521
NPI assigned
Aug 29, 2017
Last updated
Jun 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1200 SW 104TH St Ste D
Oklahoma City, OK 73139

Mailing address

1200 SW 104TH St Ste D
Oklahoma City, OK 73139-3018
Phone (405) 631-0521

Other names 1

  • Excell Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180102000659 OK Part A Provider - Hospice 7214295906 Practice locations: Oklahoma City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255858379. Details of each certification follow.

Hospice certification: CCN 371610

Legal name
PRAIRIE VIEW HEALTHCARE, INC.
Doing business as
EXCELL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 11, 2002
Last certification
Nov 19, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 3, 2017 in NV
Enrollment address
1200 SW 104TH St
Ste D
Oklahoma City, OK 73139-3018

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Excell HospiceCCN 371610 · All quality measures
Ownership
For-Profit
Certified
Dec 11, 2002
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Excell Home Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Johanna Rachel Rhodes Individual W-2 Managing EmployeeAd; Apr 21, 2026
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Direct Ownership Interest Nov 1, 2017 100%
Brent Mills Individual Corporate OfficerTreasurer Apr 20, 2026
Brent Guerisoli Individual Corporate OfficerDirector Mar 5, 2023
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019
Henry M Allen Individual Contracted Managing EmployeeMD; Jan 1, 2018
John J Gochnour Individual Corporate OfficerPresident Apr 3, 2024
Amber Tueller Individual Corporate OfficerSecretary Apr 3, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 141

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

View all 141

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2017 Change of OwnershipThis provider was the buyer Excell Home Care & Hospice, Inc.CCN 371610, OK, NPI 1881674620

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1255858379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SW 104TH ST STE D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731393018",
            "telephone_number": "405-631-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SW 104TH ST STE D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73139",
            "telephone_number": "405-631-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VIEW HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excell Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.