Edgewood Greenleaf Brookings LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

11055 Issued in SD

Legal business name

EDGEWOOD GREENLEAF BROOKINGS LLC

Practice address

2015 8TH St. S.
Brookings, SD 57006-3506

Phone

(605) 692-6311

Fax

(605) 692-1979

NPI assigned

Jul 19, 2011

Last updated

Jul 19, 2011By 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. Ron Whetter

Title

VP of Budget/Finance

Phone

(701) 738-2000

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1457649840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 8TH ST. S.",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063506",
            "telephone_number": "605-692-6311",
            "fax_number": "605-692-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 8TH ST. S.",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063506",
            "telephone_number": "605-692-6311",
            "fax_number": "605-692-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD GREENLEAF BROOKINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "WHETTER",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "VP OF BUDGET/FINANCE",
        "authorized_official_telephone_number": "701-738-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "11055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Brookings, SD
• Providers in Brookings, SD by specialty
• Assisted Living Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.