NPIMap

Organization Active NPI

Edgewater, a Wesley Active Life Community, LLC

Doing business as Edgewater, A WesleyLife Community

  • Skilled Nursing Facility
  • West Des Moines, IA
National Provider Identifier
1154560506
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EDGEWATER, A WESLEY ACTIVE LIFE COMMUNITY, LLC
Doing business as
Edgewater, A WesleyLife Community
Practice address
9225 Cascade
West Des Moines, IA 50266
Phone
(515) 978-2395
Fax
(515) 271-6898
NPI assigned
Feb 9, 2009
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
WESLEY RETIREMENT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Mr. Craig Flanagan
Title
Cfo
Phone
(515) 271-6559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

9225 Cascade
West Des Moines, IA 50266

Mailing address

5508 NW 88TH St
Johnston, IA 50131-3005
Phone (515) 978-2395

Other identifiers 1

IdentifierTypeStateIssuer
0800031MedicaidIA

Other names 1

  • Edgewater, A WesleyLife Community Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090501000365 IA Part A Provider - Skilled Nursing Facility 3274681119 Practice locations: West Des Moines, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154560506. Details of each certification follow.

Skilled nursing facility certification: CCN 165597

Legal name
EDGEWATER, A WESLEY ACTIVE LIFE COMMUNITY, LLC
Doing business as
EDGEWATER, A WESLEYLIFE COMMUNITY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 30, 2009
Last certification
Jul 15, 2024
Beds
40
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Wesley Life
Organization structure
LLCNon-profit
Incorporated
Apr 30, 2007 in IA
Enrollment address
9225 Cascade Ave
West Des Moines, IA 50266-8592
Nursing home name
EDGEWATER, A WESLEYLIFE COMMUNITY
Affiliated entity
WESLEYLIFE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edgewater, A Wesleylife CommunityCCN 165597 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 30, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4037.1 residents per day on average
Chain
Wesleylife10 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Wesley Retirement Services Inc

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christina L Taylor Individual Corporate Director Jan 1, 2018
Chad Rasmussen Individual Corporate Director Jan 1, 2011
Robert William Kretzinger Individual Corporate Officer Apr 27, 2007
Susan Watson Individual Corporate Director Jan 1, 2014
Edgewater, a Wesley Active Life Community, LLC Organization, Johnston, IA LLC Operational/Managerial Control Apr 27, 2007
Janet a Simpson Individual W-2 Managing Employee Apr 27, 2007
Roger K. Lagree Individual Corporate Director Jan 1, 2015
Abbey Gilroy Individual Corporate Director Jan 1, 2016
Kermit J Albertson Individual Corporate Director Jan 1, 2018
Nicole Lynn Hoeksema Individual Corporate Director Mar 2, 2021
David B Stout Individual Corporate Director Jan 1, 2011
Wesley Retirement Services Inc Organization, Johnston, IA Non-profit Operational/Managerial Control Feb 27, 2009
Wesleylife Organization, Johnston, IA Non-profit 5% Or Greater Direct Ownership Interest Sep 21, 2010 100%
Robert M. Ruch Individual Corporate Director Apr 27, 2007

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1154560506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 NW 88TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501313005",
            "telephone_number": "515-978-2395",
            "fax_number": "515-271-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 CASCADE",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-978-2395",
            "fax_number": "515-271-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER, A WESLEY ACTIVE LIFE COMMUNITY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESLEY RETIREMENT SERVICES",
        "enumeration_date": "2009-02-09",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-271-6559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800031",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewater, A WesleyLife Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.