Prairie Clinic SC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRAIRIE CLINIC SC

Practice address

112 Helen St
Sauk City, WI 53583

Phone

(608) 643-3351

Fax

(608) 643-3621

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Amy Lindloff

Title

Assistant Clinic Manager

Phone

(608) 643-3351

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Prairie Clinic SC2 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.

• Prairie Clinic, SC

  • Medical Physician Assistant
  • Sauk City, WI
  • NPI 1215349196
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica M. Darling, D.O.

  • Family Medicine Physician
  • Sauk City, WI
  • NPI 1134447550
  NPD

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407060791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HELEN ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "53583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HELEN ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "53583",
            "telephone_number": "608-643-3351",
            "fax_number": "608-643-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINDLOFF",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "ASSISTANT CLINIC MANAGER",
        "authorized_official_telephone_number": "608-643-3351"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0593600001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Pearson, LCSW, CSAC
• Casey Persike, PTA
• Gary Peterson
• Donald Joseph Pfau, D.C.
• Molly Pleggenkuhle, ST
• Prairie Clinic, SC
• Stephanie S. Rebenock, COTA/L
• Julie Ann Redfearn, COTA
• Taylor Rego, COTA
• Jaclyn P Rhoades

• Durable Medical Equipment & Medical Supplies in Sauk City, WI
• Providers in Sauk City, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.