Edgewood Manor Operations Management LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EDGEWOOD MANOR OPERATIONS MANAGEMENT LLC

Practice address

11900 Jessica LN
Raytown, MO 64138-2649

Phone

(816) 358-7858

NPI assigned

Feb 16, 2017

Last updated

Feb 16, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

AMO SNF MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Gerald Stoll

Title

Managing Member

Phone

(917) 836-0436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1184163677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WEDGEWOOD LN",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591451",
            "telephone_number": "917-836-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 JESSICA LN",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382649",
            "telephone_number": "816-358-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD MANOR OPERATIONS MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMO SNF MANAGEMENT LLC",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "STOLL",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "917-836-0436"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Adult Daycare Inc
• Jeanne Marie Earnest, MS
• Sydney Ann Eastman, PT, DPT
• Edgewood Manor Health Care Center, L.L.C. (Edgewood Manor Health Care Center)
• Edgewood Manor Opco, LLC (Edgewood Manor Center for Rehab and Healthcare)
• Edgewood SNF Opco LLC (Edgewood Manor Health Care Center)
• Susan Eitel, NP
• Elite Healthcare, LLC
• Emily Katherine Handley, DDS, PC (Raytown Dental Care)
• Chrishawn Estes, MSN-ED, RNC-CBC

• Skilled Nursing Facility in Raytown, MO
• Providers in Raytown, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.