NPIMap

Organization Active NPI

Prairie Ridge Integrated Behavioral Healthcare

Doing business as Prairie Ridge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mason City, IA
National Provider Identifier
1316454424
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE
Doing business as
Prairie Ridge
Practice address
320 N Eisenhower Ave
Mason City, IA 50401-1521
Phone
(641) 424-2391
Fax
(641) 424-0783
NPI assigned
Jan 10, 2018
Last updated
Jan 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Larece Annette Bartusek
Title
Office Manager
Phone
(641) 243-7222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X IA Primary

Addresses

Primary practice location

320 N Eisenhower Ave
Mason City, IA 50401-1521

Mailing address

PO Box 1338
Mason City, IA 50402-1338
Phone (641) 424-2391

Other names 1

  • Prairie Ridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prairie Ridge2 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.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1316454424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1338",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504021338",
            "telephone_number": "641-424-2391",
            "fax_number": "641-424-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N EISENHOWER AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011521",
            "telephone_number": "641-424-2391",
            "fax_number": "641-424-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "BARTUSEK",
        "authorized_official_first_name": "LARECE",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "641-243-7222"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mason City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.