Prairie Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

W82971 Issued in ID

Legal business name

PRAIRIE MEDICAL LLC

Practice address

1809 N Lakes PL
Meridian, ID 83646-1921

Phone

(208) 249-1185

Fax

(208) 938-4235

NPI assigned

Sep 30, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Tina D Newcomb, MBA, CWCMS

Title

Director/Owner

Phone

(208) 249-1185

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1588998124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 W MORGAN CREEK CT",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836163359",
            "telephone_number": "208-249-1185",
            "fax_number": "208-938-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 N LAKES PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461921",
            "telephone_number": "208-249-1185",
            "fax_number": "208-938-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "NEWCOMB",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "208-249-1185",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, CWCMS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "W82971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin J Powers, M.D.
• Erin Colleen Powers, MS, CCC-SLP
• Ppgnw - Idaho
• Practice Pros Inc
• Prairie Enterprises LLC
• Andrea Elisabeth Prasch, MD
• Esperanza Olivia Prater
• Praxair Healthcare Services, Inc.
• Precious Minds LLC
• Precision Performance and Therapy

• Durable Medical Equipment & Medical Supplies in Meridian, ID
• Providers in Meridian, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.