NPIMap

Organization Active NPI

Prairie Lakes Health Care System Inc

  • Community Based Hospice Care Agency
  • Watertown, SD
National Provider Identifier
1467480640
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRAIRIE LAKES HEALTH CARE SYSTEM INC
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
Fax
(605) 882-7607
NPI assigned
Jun 28, 2006
Organization subpart
Yes
Parent organization
PRAIRIE LAKES HEALTH CARE SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 1

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

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Other identifiers 1

IdentifierTypeStateIssuer
0154030MedicaidSD

Other names 2

  • Prairie Lakes Hospice Doing business as
  • Sanford Hospice Watertown Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080630000443 SD Part A Provider - Hospice 8628987823 Practice locations: Watertown, SD

Hospice certification: CCN 431504

Legal name
PRAIRIE LAKES HEALTH CARE SYSTEM INC
Doing business as
PRAIRIE LAKES HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 7, 1989
Last certification
May 19, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Apr 14, 1987 in SD
Enrollment address
401 9TH Ave NW
Watertown, SD 57201-1548

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Prairie Lakes HospiceCCN 431504
Ownership
Non-Profit
Certified
Aug 7, 1989
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Prarie Lakes Health Car8 organizations share this tax ID, including this one
Part of
Prarie Lakes Health Car

Other organizations with this tax ID 7

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Mark Allen Lundeen Individual Corporate DirectorBoard Member Oct 31, 2025
Marnie Lynn Ventling-Herrmann Individual Corporate OfficerVice Chairperson Oct 31, 2025
Corporate DirectorBoard Member Oct 31, 2025
Tony Lee Morrison Individual Corporate OfficerVP Chief Revenue Cycle Officer Oct 31, 2025
Brent Gerard Teiken Individual Corporate DirectorBoard Member Oct 31, 2025
Jolyn Joy Munson Individual Corporate OfficerVP Revenue Cycle Operations Oct 31, 2025
Dana James Dykhouse Individual Corporate DirectorBoard Member Oct 31, 2025
John Allen Individual Corporate OfficerPresident Oct 31, 2025
W-2 Managing EmployeePresident Feb 27, 2023
Andrew Stewart North Individual Corporate OfficerSecretary Oct 31, 2025
Corporate DirectorBoard Member Oct 31, 2025
Stephanie Marie Herseth Sandlin Individual Corporate DirectorBoard Member Oct 31, 2025
William Joseph Gassen Individual Corporate OfficerCeo Oct 31, 2025
Corporate DirectorBoard Member Oct 31, 2025
George Joseph Brown Individual Corporate OfficerTreasurer Oct 31, 2025
Corporate DirectorBoard Member Oct 31, 2025
Wesley Owen Engbrecht Individual Corporate DirectorBoard Member Oct 31, 2025
Sanford Health Network Organization, Sioux Falls, SD Medical provider/supplier, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 31, 2025 100%
Maureen Patricia McCausland Individual Corporate DirectorBoard Member Oct 31, 2025
Sanford Organization, Fargo, ND Chain home office 5% Or Greater Indirect Ownership Interest Oct 31, 2025 100%
Michele Turbak Individual W-2 Managing EmployeeCno Jan 1, 2007
Thomas Richard Wenzel Individual Corporate DirectorBoard Member Oct 31, 2025
David Jonathan Shulkin Individual Corporate DirectorBoard Member Oct 31, 2025
Sanford Health Organization, Sioux Falls, SD Medical provider/supplier, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 31, 2025 100%
Neil Leslie Gulsvig Individual Corporate DirectorBoard Member Oct 31, 2025
Kevin Victor Schieffer Individual Corporate DirectorBoard Member Oct 31, 2025
Lauris Nelson Molbert Individual Corporate OfficerChairperson Oct 31, 2025
Corporate DirectorBoard Member Oct 31, 2025
Nicholas Wayne Olson Individual Corporate OfficerCfo Oct 31, 2025

Facilities with the same owner 54

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

View all 54

Practitioners & affiliated clinicians

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1467480640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE LAKES HEALTH CARE SYSTEM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRAIRIE LAKES HEALTH CARE SYSTEM INC",
        "enumeration_date": "2006-06-28",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154030",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Lakes Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Hospice Watertown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.