PRAIRIE MANOR
NPI 1164844866
Skilled Nursing Facility in Wilsonville, OR

Active since January 15, 2014CLIA 14D0903524 · Waiver
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070(708) 754-7601 Get Directions Write a Review

NPPES record last updated: January 15, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prairie Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAIRIE MANOR (NPI 1164844866) is a healthcare organization registered as a skilled nursing facility in Wilsonville, Oregon and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through July 23, 2027 and lists Rosemarie M Smith, Certified Occupational Therapy Assi, as its authorized official.

NPPES Registry Identity

NPI1164844866
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePRAIRIE MANOR
Location Address25117 SW PARKWAY AVE, SUITE DWilsonville, OR 97070-9697
Mailing Address25117 Sw Parkway Ave, Suite DWilsonville, OR 97070-9697
Organization SubpartYesParent: Yes
Authorized OfficialRosemarie M SmithCertified Occupational Therapy Assi · (708) 474-3116
Enumeration DateJanuary 15, 2014
NPI 1164844866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IL · 057001429
Definition

(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.

25117 SW PARKWAY AVE, Wilsonville, OR 97070

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0903524

Prairie Manor Nursing And Rehab Care Centers Inc · Chicago Heights, IL
Active · expires Jul 23, 2027
CLIA Number14D0903524
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorSanjeer Joshi MD
Laboratory Phone(708) 754-7601
Laboratory LocationPrairie Manor Nursing And Rehab Care Centers Inc345 Dixie Highway, Chicago Heights, IL 60411
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Durable Medical Equipment & Medical Supplies (Nursing Facility Supplies)
25117 SW PARKWAY AVE, STE F
WILSONVILLE, OR 97070
Specialist
25117 SW PARKWAY AVE, STE D
WILSONVILLE, OR 97070
Physical Therapist
25117 SW PARKWAY AVE, STE.D
WILSONVILLE, OR 97070
Physical Therapist (Geriatrics)
25117 SW PARKWAY AVE
WILSONVILLE, OR 97070
Physical Therapist (Geriatrics)
25117 SW PARKWAY AVE, STE D
WILSONVILLE, OR 97070
Physical Therapist
25117 SW PARKWAY AVE, SUITE D
WILSONVILLE, OR 97070
Occupational Therapist
25117 SW PARKWAY AVE, STE D
WILSONVILLE, OR 97070
Physical Therapist
25117 SW PARKWAY AVE, SUITE D
WILSONVILLE, OR 97070

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164844866, enumerated as an "organization" on January 15, 2014.

The provider is located at 25117 SW PARKWAY AVE SUITE D WILSONVILLE, OR 97070 and the phone number is (708) 754-7601.

Skilled Nursing Facility with taxonomy code 314000000X.