PRAIRIE BLUFFS TCU, LLC
NPI 1770193872
Skilled Nursing Facility in Eden Prairie, MN

NPI Status: Active since August 04, 2020

Contact Information

10300 HENNEPIN TOWN RD
EDEN PRAIRIE, MN
ZIP 55347
Phone: (952) 444-5000
Fax: (952) 204-3024

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Skilled Nursing Facility
CLIA Number: 24D2179421
CLIA Cert. Type: Assisted Living Facility
CLIA Exp. Date: 02-23-2026

About PRAIRIE BLUFFS TCU, LLC

This page provides the complete NPI Profile along with additional information for Prairie Bluffs Tcu, Llc, a provider established in Eden Prairie, Minnesota operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1770193872 assigned on August 2020. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Chris Krebsbach Lnha (Coo)

NPI: 1770193872
Provider Name: PRAIRIE BLUFFS TCU, LLC
Entity Type: Organization
Location Address: 10300 HENNEPIN TOWN RD EDEN PRAIRIE, MN 55347
Location Phone: (952) 444-5000
Location Fax: (952) 204-3024
Mailing Address: 10300 HENNEPIN TOWN ROAD EDEN PRAIRIE, MN 55347
Mailing Phone: (952) 444-5000
Mailing Fax: (952) 204-3024
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 08-04-2020
Last Update Date: 11-04-2022
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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
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: CHRIS KREBSBACH LNHA
Authorized Official Title: COO
Authorized Official Phone: (612) 202-4553

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
409168	MEDICAID (05)	MN

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: 24D2179421
Facility Type: Assisted Living Facility
Certificate Effective Date: February 24, 2024
Certificate Expiration Date: February 23, 2026
Laboratory Director: STEPHANIE FREDERICK
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Prairie Bluffs Tcu, Llc 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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	7	0	1	9	3	8	7	2
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	14	0	2	9	6	8	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 4 + 0 + 2 + 9 + 6 + 8 + 1 + 4 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 2									2

The NPI number 1770193872 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.