Prairie View Leasing
Organization Active NPI Skilled Nursing Facility · Sanborn, IA
NPI 1487715751 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1487715751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- N-410 (IA)
- Legal business name
- PRAIRIE VIEW LEASING
- Practice address
- 610 N Eastern St
Sanborn, IA 51248-1089 - Phone
- (712) 930-3228
- Fax
- (712) 930-3138
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Wendy M Nelson III
- Title
- Administartor
- Phone
- (712) 930-3228
Owners & managing parties with NPI records 5
-
Terry Leslie Boelter, D.D.S.
-
Scott Alan Lichty, M.D.
Corporate family (same tax ID) 1
Affiliated clinicians 3
-
Amy Margreta Badberg, M.D.
-
Scott Alan Lichty, M.D.
-
Amy L Wingert, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Prairie View Home
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 1, 2006
- Medicare certification status
- Active
- Certified beds
- 55 · 43.1 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Skilled nursing facility certification: CCN 165574
- Legal name
- PRAIRIE VIEW LEASING
- Doing business as
- PRAIRIE VIEW HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 2006
- Last certification
- Aug 8, 2024
- Beds
- 55
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 610 N Eastern St
Sanborn, IA 51248-1089 - Nursing home name
- PRAIRIE VIEW HOME
All disclosed owners & managing parties 69
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Mar 1, 2021 | |
| Charlotte F Kooima |
Adp of the SNF | Jan 1, 2022 | |
| James Patrick Cravens |
Corporate Officer |
Mar 1, 1982 | 11% |
| Corporate Director |
Mar 1, 1982 | 9% | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| NCS Healthcare of Iowa, LLC |
Adp of the SNF | Mar 1, 2021 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Thomas Nelson |
Operational/Managerial Control | May 17, 2021 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Lowell D Appleton |
Corporate Director |
Aug 1, 2009 | 9% |
| |
Adp of the SNF | Oct 1, 2024 | |
| Blue Stone Therapy Inc |
Adp of the SNF | Mar 17, 2023 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| Brent Vanderwerff |
Corporate Director |
Mar 1, 2018 | |
| Mackenzie Jenness |
Corporate Director |
Mar 1, 2025 | |
| Magdelena Schwarz |
Operational/Managerial Control | Jun 25, 2024 | |
| Karissa a Getting |
Corporate Director |
May 1, 2023 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Wendy Marie Nelson |
Operational/Managerial Control | Feb 7, 2025 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| John Haack |
Corporate Director |
Mar 1, 2023 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Chris Wolters |
Corporate Officer |
Mar 1, 2017 | |
| |
Adp of the SNF | Jun 1, 1998 | |
| Rdi Computer Networking |
Adp of the SNF | Dec 31, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Cattail Inc |
Adp of the SNF | Oct 1, 2024 | |
| Jeffery Kroese |
Corporate Director | Aug 1, 2022 | |
| BCG Holdings Inc |
Adp of the SNF | Oct 1, 2024 | |
| Rachel Wilson |
Operational/Managerial Control | May 25, 2017 | |
| Nancy Vandyke |
Corporate Officer |
Mar 1, 2016 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Iowa Health Care Association |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Jun 1, 1998 | |
| Stacey Dagel |
Operational/Managerial Control | Nov 24, 1972 | |
| Jennifer Prins |
Corporate Officer |
Jul 1, 2022 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Seth Postma |
Corporate Officer | Mar 1, 2021 | |
| |
Adp of the SNF | Dec 31, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Mar 17, 2023 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Ecsi Inc |
Adp of the SNF | Oct 1, 2024 | |
| Direct Ownership Interest | Oct 1, 2024 | 25% | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Jun 1, 1998 | |
| Terry Leslie Boelter |
Corporate Director |
Apr 1, 2004 | 9% |
| K F Murphy Co PC |
Adp of the SNF | Jun 1, 1998 | |
| |
Adp of the SNF | Mar 1, 2021 | |
| Dudley McDowell |
Corporate Director |
Apr 14, 2014 | 11% |
| |
Adp of the SNF | Mar 1, 2021 | |
| Scott a Lichty |
Operational/Managerial Control | Jan 3, 2007 | |
| Adp of the SNF | Nov 21, 2025 | ||
| |
Adp of the SNF | Mar 1, 2021 | |
| Cattail BCG LLC |
Adp of the SNF | Oct 1, 2024 | |
| Jeffrey P Queck |
Corporate Director |
Jan 1, 1998 | 9% |
| |
Adp of the SNF | Oct 1, 2024 | |
| Brighton Consulting Group LLC |
Adp of the SNF | Oct 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111017000010 | IA | Part a Provider - Skilled Nursing Facility | 1456369370 | Practice locations: Sanborn, IA |
National Provider Directory
- Tax ID family
- Prairie View
Locations
610 N Eastern St
Sanborn, IA 51248
Phone (712) 728-2702
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | |||
| Skilled Nursing Facility | 314000000X | N-410 | IA | Yes |
Addresses
Primary practice location
610 N Eastern St
Sanborn, IA 51248-1089
Mailing address
610 N Eastern St
Sanborn, IA 51248-1089
Phone (712) 930-3228
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0803320 | Medicaid | IA |
Other providers in Sanborn, IA
- Family Health Chiropractic, P.C.
- Jamie J. Gross
- Jacqueline Dee Kramer
- Mitchell Ludwig
- Prairie View
- Melissa S Rupp
- Sanborn Chiropractic Clinic PC
- Sanford Health Network
- Sanford Health Network
- Terry L Boelter DDS PC
All providers in Sanborn, IA · Skilled Nursing Facility in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.