PRAIRIE CLINIC LLC NPI 1740992676

NPI Information

NPI: 1740992676
Provider Name: PRAIRIE CLINIC LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 06D2291005

Address:
172 WEST 1ST
SPRINGFIELD, CO
ZIP 81073
Phone: (719) 691-4488
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PRAIRIE CLINIC LLC is a primary care clinic center in Springfield, CO. PRAIRIE CLINIC LLC NPI is 1740992676. The provider is registered as an organization entity type.

The provider's business location address is:

172 WEST 1ST
SPRINGFIELD, CO
ZIP 81073-107
Phone: (719) 691-4488

The provider's authorized official is Tennille Ann Rau .
The authorized official title is Llc Member/medical Provider and has the following contact phone number (719) 691-4642.

The CLIA number assigned to this NPI record is 06D2291005 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2022 and was last updated on 10/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1114384138	OTHER	COLORADO	NPI 1

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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