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PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC
NPI 1306920319
Pediatrics - Pediatric Cardiology in Sioux City, IA

Active since October 25, 2006CLIA Certified · 2 labs
1125 PIERCE ST, SIOUX CITY, IA 51105(712) 255-8901(712) 255-9161 Get Directions Write a Review

NPPES record last updated: January 27, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Prairie Pediatrics & Adolescent Clinic, Pc NPPES

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

PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC (NPI 1306920319) is a healthcare organization registered as a pediatric cardiology in Sioux City, Iowa and active in the NPI registry since October 2006. The organization holds 2 active CLIA laboratory certificates and lists Melanie Olsen, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1306920319
Entity TypeOrganization
Primary Taxonomy2080P0202X
Legal Business NamePRAIRIE PEDIATRICS, PC
Location Address1125 PIERCE STSioux City, IA 51105-1485
Mailing Address1125 Pierce StSioux City, IA 51105-1485 · (712) 255-8901 · Fax (712) 255-9161
Phone(712) 255-8901
Fax(712) 255-9161
Organization SubpartNo
Authorized OfficialMelanie OlsenBusiness Manager · (712) 255-8901
Enumeration DateOctober 25, 2006
Last NPPES UpdateJanuary 27, 2015
✔ NPI 1306920319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

1125 PIERCE ST, Sioux City, IA 51105
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Other Names 1

Doing Business AsPrairie Pediatrics & Adolescent Clinic, Pc

Other Identifiers 2

Other51104A001IA · Tricare Entity Id
Medicare PIN71992IA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 16D0951645

Prairie Pediatrics And Adolescent Clinic · Sioux City, IA
Active · expires Sep 22, 2026
CLIA Number16D0951645
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2024
Certificate Expiration DateSeptember 22, 2026
Laboratory DirectorNitya L. Brenner
Laboratory Phone(712) 255-8901
Laboratory LocationPrairie Pediatrics And Adolescent Clinic1125 Pierce St, Sioux City, IA 51105
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 16D0385234

Prairie Pediatrics & Adolescent Clinic PC · Sioux City, IA
Active · expires Aug 31, 2026
CLIA Number16D0385234
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Ray C. Sturdevant
Laboratory Phone(712) 255-8901
Laboratory LocationPrairie Pediatrics & Adolescent Clinic PC1125 Pierce Street, Sioux City, IA 51105
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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.

DR. EYAD K NAJDAWI MD
Pediatrics (Pediatric Cardiology)
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
LINDSAY VAN DYKE ARNP
Nurse Practitioner (Family)
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
MRS. MELANIE DAWN LUND RN, PEDIATRIC CNP
Nurse Practitioner (Pediatrics)
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
JANET BLACK RN
Registered Nurse
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
SUSAN B SORENSON ARNP
Nurse Practitioner
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
LISA DEROCHER RN
Registered Nurse
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
RITA NELSON RN
Registered Nurse
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 255-8901
MERCY MEDICAL SERVICES
Counselor
1125 PIERCE ST
SIOUX CITY, IA 51105
Woodbury County (712) 258-6780

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prairie Pediatrics, PC's NPI number?

The NPI number for Prairie Pediatrics, PC is 1306920319. It was assigned to this organization in the NPPES registry on October 25, 2006. The provider is doing business as Prairie Pediatrics & Adolescent Clinic, PC.

Where is Prairie Pediatrics, PC located?

Prairie Pediatrics, PC is located at 1125 Pierce St, Sioux City, IA 51105. The listed phone number is (712) 255-8901.

What is Prairie Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Does Prairie Pediatrics, PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Prairie Pediatrics, PC accept?

Health plans from Sanford Health Plan list Prairie Pediatrics, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prairie Pediatrics, PC was last updated on January 27, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.