Ridgeway Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

03032 Issued in MD

Legal business name

RIDGEWAY MANOR INC

Practice address

5743 Edmondson Ave
Catonsville, MD 21228

Phone

(410) 747-5250

Fax

(410) 747-8050

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Edgar Burleigh III, NURSING HOME ADMINIS

Title

Administrator

Phone

(410) 747-5250

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ridgeway Manor Nursing Home Doing business as

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1386700342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5743 EDMONDSON AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "21228",
            "telephone_number": "410-747-5250",
            "fax_number": "410-747-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 EDMONDSON AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "21228",
            "telephone_number": "410-747-5250",
            "fax_number": "410-747-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWAY MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "BURLEIGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-747-5250",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "NURSING HOME ADMINIS"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "03032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59005301",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032927400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeway Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Ina Reynolds, LMT
• Reznride ,LLC
• Rhema Home Health Services LLC
• Richard H. Schreder, PH.D., P.a.
• Charles Michael Richardson, M.D.
• Ridgeway Rehab
• Julie Riffle
• Stephanie Riley
• Donald Kenneth Rinker III
• River Birch Counseling, LLC

• Skilled Nursing Facility in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.