NPIMap

Organization Active NPI

Prairie View Management, Inc.

  • Custodial Care Facility
  • Fayette, IA
National Provider Identifier
1477634236
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
R-279 Issued in IA
Legal business name
PRAIRIE VIEW MANAGEMENT, INC.
Practice address
18569 Lane Rd
Fayette, IA 52142-9525
Phone
(563) 422-5606
Fax
(563) 422-5607
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ann Bunn
Title
Administrator
Phone
(563) 422-5606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X R-279 IA Primary

Addresses

Primary practice location

18569 Lane Rd
Fayette, IA 52142-9525

Mailing address

18569 Lane Rd
Fayette, IA 52142-9525
Phone (563) 422-5606

Other identifiers 3

IdentifierTypeStateIssuer
0107847MedicaidIA
1234484MedicaidIA
0893800MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Prairie View Management Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477634236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18569 LANE RD",
            "city": "FAYETTE",
            "state": "IA",
            "postal_code": "521429525",
            "telephone_number": "563-422-5606",
            "fax_number": "563-422-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18569 LANE RD",
            "city": "FAYETTE",
            "state": "IA",
            "postal_code": "521429525",
            "telephone_number": "563-422-5606",
            "fax_number": "563-422-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VIEW MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "563-422-5606"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "IA",
            "license": "R-279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107847",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234484",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893800",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayette, IA

Sources for this page

  • 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.