PRAIRIE MANOR (NPI# 1164844866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164844866 |
| Entity Type | Organization |
| Organization Name | PRAIRIE MANOR |
| Practice Address |
25117 Sw Parkway Ave Suite D Wilsonville OR 97070-9697 |
| Practice Telephone | 7087547601 |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |
| Authorized Official Name | MRS. ROSEMARIE M SMITH (CERTIFIED OCCUPATIONAL THERAPY ASSI) |
| Authorized Official Telephone | 7084743116 |
| Authorized Official Credential | COTA/L |
| Is Organization Subpart | Y |
| Parent Organization Name | YES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 057001429 | IL | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PRAIRIE MANOR LLC | 14917 Ne 123rd Avenue, Vancouver, WA 98686 |
| Street Address |
25117 SW PARKWAY AVE SUITE D |
| City | WILSONVILLE |
| State | OR |
| Zip Code | 97070-9697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104829258 | Avamere Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 25117 Sw Parkway Ave, Ste F, Wilsonville, OR 97070-9697 | 2005-05-23 |
| 1184151805 | Jessica Beers | Speech-Language Pathologist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-05-11 |
| 1497280044 | Matthew Wayne | Physical Therapy Assistant | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070 | 2017-04-20 |
| 1336673029 | Mary Lawrence Williams | Physical Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-04-19 |
| 1447790191 | Rebecca Lauren Reinhardt | Occupational Therapist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-28 |
| 1821537911 | Catherine Bonde | Occupational Therapist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-22 |
| 1154860419 | Joy Hallett | Occupational Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-02-20 |
| 1205374931 | Lauryl James | Physical Therapist | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2017-02-01 |
| 1992243620 | Danielle Fernanda Jackovitz | Speech-Language Pathologist | 25117 Sw Parkway Ave, Ste D, Wilsonville, OR 97070-9697 | 2017-02-01 |
| 1124562822 | Andrea Earnest | Occupational Therapy Assistant | 25117 Sw Parkway Ave, Suite D, Wilsonville, OR 97070-9697 | 2016-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995896 | Rosalyn Sharon Mckinney | Technician | 7798 Sw Vlahos Dr, Wilsonville, OR 97070 | 2019-10-29 |
| 1275027393 | Oregon Regeneration Stem Cell Medical Center, LLC | Chiropractor | 29781 Sw Town Center Loop, Wilsonville, OR 97070 | 2018-06-21 |
| 1073050472 | Kirstin Marie Lauritzen | Chiropractor | 25589 Sw Canyon Creek Rd Ste 100, Wilsonville, OR 97070 | 2017-01-23 |
| 1932642220 | Nicole Galasso | Occupational Therapy Assistant | 25117 Sw Parkway Avenue Suite D, Wilsonville, OR 97070 | 2016-11-18 |
| 1508317512 | Justin Langlais | Naturopath | 25195 Sw Parkway Ave Ste 210, Wilsonville, OR 97070 | 2016-10-14 |
| 1518411149 | Stephanie Tran | Optometrist | 29250 Town Center Loop W, Wilsonville, OR 97070 | 2016-08-11 |
| 1346610607 | Rachel Ziegler | Occupational Therapy Assistant | 25117 Sw Parkway Ave Suite D, Willsonville, OR 97070 | 2015-09-30 |
| 1992184238 | Michelle Miranda | Counselor | 30150 Sw Parkway Ave Ste 300, Wilsonville, OR 97070 | 2015-05-19 |
| 1609275007 | Ryan Bridges | Dentist | 30040 Sw Boones Ferry Rd Ste 20, Wilsonville, OR 97070 | 2014-08-21 |
| 1649604018 | Jason Russell James | Physical Therapist | 29174 Sw Town Center Loop W # 202b, Wilsonville, OR 97070 | 2013-08-21 |
| Find all providers in zip 97070 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972915270 | Melissa King | Skilled Nursing Facility | 25117 Sw Parkway Ave Ste D, Wilsonville, OR 97070-9697 | 2014-05-21 |
| 1679916266 | Marquis Companies II, Inc. | Skilled Nursing Facility | 30900 Sw Parkway Ave, Wilsonville, OR 97070-7835 | 2013-04-12 |
| 1396032488 | Karen Nagao | Skilled Nursing Facility | 25117 Sw Parkway Ave Ste D, Wilsonville, OR 97070-9697 | 2011-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1689231383 | Marquis Companies I Inc | Skilled Nursing Facility | 410 Se Church Street, Sublimity, OR 97385 | 2019-05-29 |
| 1720528003 | Rashelle M Johnson | Skilled Nursing Facility | 2457 Ne Bobbi Pl, Prineville, OR 97754-9089 | 2017-03-06 |
| 1881133254 | Jessie Steele | Skilled Nursing Facility | 2693 Nw Crossing Dr, Bend, OR 97703-7347 | 2017-02-18 |
| 1063969988 | Set Op Co | Skilled Nursing Facility | 1220 20th St Se, 310, Salem, OR 97302-1205 | 2016-09-08 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| 1710336672 | Lauren Biamont | Skilled Nursing Facility | 5748 Smoketree Dr Se, Salem, OR 97306-1260 | 2016-06-10 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1508250762 | West Linn Care Ctr Operating Co, LLC | Skilled Nursing Facility | 2330 Deok Rd., West Linn, OR 97068-3902 | 2015-03-26 |
| 1568871770 | Keizer River Operations, LLC | Skilled Nursing Facility | 450 Clagett Ct. N, Keizer, OR 97303-4400 | 2014-08-13 |
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| City | WILSONVILLE |
| Zip Code | 97070 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.