Edgewood May Creek LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EDGEWOOD MAY CREEK LLC

Doing business as

May Creek

Practice address

303 10TH Street South
Walker, MN 56484

Phone

(701) 757-5465

NPI assigned

Jul 6, 2015

Last updated

Jul 6, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Rex Carlson

Title

Cfo

Phone

(701) 757-5465

Specialties & licenses 1

Addresses

Other names 1

• May Creek Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Edgewood May Creek LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Edgewood May Creek LLC

  dba May Creek

  • Assisted Living Facility
  • Walker, MN
  • NPI 1427432996
  NPD tax ID
• Edgewood May Creek LLC

  dba May Creek

  • Assisted Living Facility
  • Walker, MN
  • NPI 1972988509
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1053794362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 10TH ST SOUTH",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "564844754",
            "telephone_number": "701-757-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 10TH STREET SOUTH",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "56484",
            "telephone_number": "701-757-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD MAY CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-06",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-757-5465",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "May Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Cotter, LMFT
• Dakota Clinic LTD (Dakota Clinic LTD Walker)
• Dakota Clinic, LTD. (Dakota Clinic, Ltd. - Walker)
• Danielle Cotter Dba C3 Mental Health
• Zachary Taylor Dukleth, DDS
• Edgewood May Creek LLC (May Creek)
• Edgewood May Creek LLC (May Creek)
• Angela Marie Emmeck
• Rachel Diane Erickson, APRN, CNP
• David Farder

• Assisted Living Facility in Walker, MN
• Providers in Walker, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.