Prairie View Medical, Prof. LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRAIRIE VIEW MEDICAL, PROF. LLC

Doing business as

Prairie View Medical Clinic

Practice address

3405 6TH St Ste 5
Brookings, SD 57006-4401

Phone

(605) 695-6712

NPI assigned

Dec 28, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Olson, MDNPI 1285623439

Title

President/Ceo

Phone

(605) 693-7862

Specialties & licenses 1

Addresses

Other names 1

• Prairie View Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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

• Jennifer Lea Olson, MD

  • Family Medicine Physician
  • Brookings, SD
  • NPI 1285623439
  Medicare reassignment Care Compare group NPD Authorized official
• Jodi L Jung, CNP

  • Family Nurse Practitioner
  • Brookings, SD
  • NPI 1609103977
  Medicare reassignment Care Compare group NPD
• Julie K Rasmussen, PAC

  • Physician Assistant
  • Clear Lake, SD
  • NPI 1447239942
  Medicare reassignment

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1508635772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 6TH ST STE 5",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570064401",
            "telephone_number": "605-693-7862",
            "fax_number": "605-693-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 6TH ST STE 5",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570064401",
            "telephone_number": "605-695-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VIEW MEDICAL, PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-693-7862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie View Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prairie View Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian L Piearson, OD
• Pietz-Coats Optometry Inc
• Theresa Plut, MA
• Jackson Roland Pond, OD
• Madelyn Rae Ponto, CNP
• Pro PT, Inc.
• Caitlin Proechel
• Prouty Brookings Dental, LLC
• Ryan Daniel Prusa, DPM
• Jennifer Prussman, PHARMD

• Primary Care Clinic/Center in Brookings, SD
• Providers in Brookings, SD by specialty
• Primary Care Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.