Village of Prairie Farm

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1056 Issued in WI

Legal business name

VILLAGE OF PRAIRIE FARM

Doing business as

Pioneer Nursing Home

Practice address

530 River Avenue South
Prairie Farm, WI 54762

Phone

(715) 455-1178

Fax

(715) 455-1044

NPI assigned

Jul 8, 2005

Organization subpart

No

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

Authorized official

Name

Amy Duhr

Title

Ceo

Phone

(715) 832-3003

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pioneer Nursing Home Doing business as

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1932107463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RIVER AVENUE SOUTH",
            "city": "PRAIRIE FARM",
            "state": "WI",
            "postal_code": "54762",
            "telephone_number": "715-455-1178",
            "fax_number": "715-455-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 RIVER AVENUE SOUTH",
            "city": "PRAIRIE FARM",
            "state": "WI",
            "postal_code": "54762",
            "telephone_number": "715-455-1178",
            "fax_number": "715-455-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF PRAIRIE FARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "DUHR",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-832-3003"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20156100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pioneer Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adam Keapproth
• Erika Krzmarzick, COTA/L
• Tanya Leahy
• Barbara Jo Nigon
• School District of Prairie Farm

• Skilled Nursing Facility in Prairie Farm, WI
• Providers in Prairie Farm, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.