Edgewood Maximus Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EDGEWOOD MAXIMUS OPERATIONS LLC

Practice address

1771 Edgewood Ave W
Jacksonville, FL 32208-3278

Phone

(904) 766-7436

NPI assigned

Nov 25, 2019

Organization subpart

Yes

Parent organization

MAXIMUS HEALTHCARE GROUP LLCAs reported in NPPES

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

Authorized official

Name

Lynne Place

Title

VP of Finance

Phone

(828) 322-8171

Specialties & licenses 1

Addresses

Other names 1

• Edgewood Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1770129793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9268",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286039268",
            "telephone_number": "828-322-8171",
            "fax_number": "828-322-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 EDGEWOOD AVE W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322083278",
            "telephone_number": "904-766-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD MAXIMUS OPERATIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAXIMUS HEALTHCARE GROUP LLC",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "PLACE",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "828-322-8171"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Edenfield
• Victoria Edenfield, ARNP
• Diana L Edgar, M.D.
• Krystal Kay Edgar, CRNA
• Robin L Edge, SLP-CCC
• Edgewood Nursing Center Inc
• Jonathon Curtis Edgy, MD
• Peter Ediagbonya, RPH
• Stefanie Ann Edinger, PHARMD
• Teresa A. Edison, ARNP

• Skilled Nursing Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.