Edgewood Pierre LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

66437 Issued in SD

Legal business name

EDGEWOOD PIERRE LLC

Practice address

1950 E 4TH St
Pierre, SD 57501-4201

Phone

(605) 494-3400

NPI assigned

Dec 4, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Rex Carlson

Title

Treasurer

Phone

(701) 757-5463

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

Locations

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1730554577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DEMERS AVE STE 500",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014799",
            "telephone_number": "701-757-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E 4TH ST",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575014201",
            "telephone_number": "605-494-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD PIERRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "701-757-5463",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "66437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teddi Liane Dowling
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• Jeff Ekle, MA LPC CAC
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• Cindy D. Erwin, P.A.-C.
• Tara Espland, MS

• Assisted Living Facility in Pierre, SD
• Providers in Pierre, 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 Dec 4, 2015; 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.