PRAIRIE MANOR
NPI 1164844866
Skilled Nursing Facility in Wilsonville, OR
NPI Status: Active since January 15, 2014
Contact Information
25117 SW PARKWAY AVE
SUITE D
WILSONVILLE, OR
ZIP 97070
Phone: (708) 754-7601
- Organization
- Skilled Nursing Facility
- CLIA Number: 14D0903524
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 07-23-2027
About PRAIRIE MANOR
This page provides the complete NPI Profile along with additional information for Prairie Manor, a provider established in Wilsonville, Oregon operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1164844866 assigned on January 2014. The practitioner's primary taxonomy code is 314000000X with license number 057001429 (IL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mrs. Rosemarie M Smith Cota/l (Certified Occupational Therapy Assi)
- NPI
- 1164844866
- Provider Name
- PRAIRIE MANOR
- Entity Type
- Organization
- Location Address
- 25117 SW PARKWAY AVE SUITE D WILSONVILLE, OR 97070
- Location Phone
- (708) 754-7601
- Mailing Address
- 25117 SW PARKWAY AVE SUITE D WILSONVILLE, OR 97070
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 01-15-2014
- Last Update Date
- 01-15-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 057001429
- License State
- IL
- Taxonomy Description
- (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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0903524
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- July 24, 2025
- Certificate Expiration Date
- July 23, 2027
- Laboratory Director
- SANJEER JOSHI MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Prairie Manor to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164844866, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
WILSONVILLE, OR 97070
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.
