NPIMap

Organization Active NPI

Prairie Manor Inc.

Doing business as Heather Haus

  • Skilled Nursing Facility
  • Blooming Prairie, MN
National Provider Identifier
1356343701
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
325518 Issued in MN
Legal business name
PRAIRIE MANOR INC.
Doing business as
Heather Haus
Prairie Manor Care Center
Practice address
220 3Rd St NW
Blooming Prairie, MN 55917-1121
Phone
(507) 583-4434
Fax
(507) 583-2401
NPI assigned
Aug 15, 2005
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Brittany Alexander
Title
Business Office Manager
Phone
(507) 572-6193

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU
Skilled Nursing Facility 314000000X 325518 MN Primary

Addresses

Primary practice location

220 3Rd St NW
Blooming Prairie, MN 55917-1121

Mailing address

220 3Rd St NW
Blooming Prairie, MN 55917-1121
Phone (507) 583-4434

Other identifiers 1

IdentifierTypeStateIssuer
122343700MedicaidMN

Other names 2

  • Heather Haus Doing business as
  • Prairie Manor Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100429001149 MN Part A Provider - Skilled Nursing Facility 3577690122 Practice locations: Blooming Prairie, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356343701. Details of each certification follow.

Skilled nursing facility certification: CCN 245482

Legal name
PRAIRIE MANOR, INC
Doing business as
PRAIRIE MANOR CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1987
Last certification
Jul 2, 2024
Beds
39
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1966 in MN
Enrollment address
220 3Rd St NW
Blooming Prairie, MN 55917-1121
Nursing home name
PRAIRIE MANOR CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Prairie Manor Care CenterCCN 245482 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3937.0 residents per day on average
Penalties (3 years)
2Fines totaling $43,300

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0726320Prairie Manor Inc220 3Rd St NW, Blooming Prairie, MN 55917Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

220 3rd St NW
Blooming Prairie, MN 55917
Phone (507) 583-4434

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Julie Peterson Individual Corporate DirectorVice President Jan 1, 2016
Shadrick Rudlong Individual Corporate DirectorSecretary Jan 1, 2016
Douglas Johnson Individual Corporate DirectorPresident Jan 1, 2015
Individual Adp of the SNF Nov 1, 2024
Marianne Peterson Individual Operational/Managerial Control Feb 15, 2011
Adp of the SNF Feb 15, 2011
Wipfli LLP Organization, Minneapolis, MN Corporation, LLC Operational/Managerial Control Dec 31, 2024
Adp of the SNF Dec 31, 2024
Joseph Mason Individual Corporate OfficerPoa & Declaration of Representative Mar 13, 2019
Operational/Managerial Control Jan 8, 2018
Adp of the SNF Jan 8, 2018
Roger Manges Individual Corporate DirectorBoard Director Jan 1, 2023
William Newman Individual Corporate DirectorTreasurer Jan 1, 2017

Facilities with the same owner 65

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

View all 65

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 2

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": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1356343701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 3RD ST NW",
            "city": "BLOOMING PRAIRIE",
            "state": "MN",
            "postal_code": "559171121",
            "telephone_number": "507-583-4434",
            "fax_number": "507-583-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 3RD ST NW",
            "city": "BLOOMING PRAIRIE",
            "state": "MN",
            "postal_code": "559171121",
            "telephone_number": "507-583-4434",
            "fax_number": "507-583-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE MANOR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "507-572-6193"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "325518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122343700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heather Haus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prairie Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blooming Prairie, MN

Sources for this page

Verify at the official NPI Registry.