Wedgewood SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WEDGEWOOD SNF LLC

Doing business as

Wedgewood Nursing Home

Practice address

6621 Dan Danciger Rd
Fort Worth, TX 76133-4905

Phone

(817) 292-6330

NPI assigned

Sep 30, 2009

Last updated

Oct 21, 2009By 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

Zevi Kohn

Title

Cfo

Phone

(718) 412-3522

Specialties & licenses 2

Addresses

Other names 1

• Wedgewood Nursing Home Doing business as

Locations

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1174857676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E RANDOL MILL RD",
            "address_2": "SUITE 630",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760116315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 DAN DANCIGER RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761334905",
            "telephone_number": "817-292-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGEWOOD SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "ZEVI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-412-3522"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wedgewood Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Dominic Wechsler Jr., PA-C
• Geoffrey W. Weckel, LPC
• Kati Nicole Weckman
• Ciara L Weddborn, LPC INTERN
• Wedgewood Nursing Home, L.P. (Wedgewood Nursing Home)
• Wedgwood Eyecare PC (Visualeyes)
• Hannah Elizabeth Weeks
• Natalie Lillian Weeks, PT
• Rachael Weeks
• Susan Weeks, MS, RN, LMFT, LCDC

• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.