Prairie Village Care, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PRAIRIE VILLAGE CARE, LLC

Practice address

801 S State Road 57
Washington, IN 47501-4373

Phone

(812) 254-4516

Fax

(812) 254-4765

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Donna Jo Maassen

Title

Director of Compliance

Phone

(414) 908-8119

Specialties & licenses 1

Addresses

Other names 1

• Prairie Village Nursing and Rehab Center Doing business as

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1669543286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032903",
            "telephone_number": "414-908-8119",
            "fax_number": "414-908-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S STATE ROAD 57",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014373",
            "telephone_number": "812-254-4516",
            "fax_number": "812-254-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VILLAGE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "MAASSEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "414-908-8119"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Village Nursing and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Josephine Pickett
• Korinne Elizabeth Pinkstaff, RN
• Lucas Pittman, APN
• Lynda Plummer, AGACNP-BC
• Taylor Ann Popp, NP
• Precision Eyecare Inc.
• Prescription Shoppe LLC
• Joanna Primeau, PHD,HSPP
• Procare Rehab and Wound Solutions Prof Corp
• Tammie Lynn Purcell, CRNA

• Skilled Nursing Facility in Washington, IN
• Providers in Washington, IN by specialty
• Skilled Nursing Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.