Organization Active NPI

Hammer Residences, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Wayzata, MN
National Provider Identifier
1811919996
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
HAMMER RESIDENCES, INC.
Practice address
1909 Wayzata Blvd
Wayzata, MN 55391-2047
Phone
(952) 473-1261
Fax
(952) 473-8629
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Mr. John Estrem
Title
Chief Executive Officer
Phone
(952) 277-2422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X MN Primary

Addresses

Primary practice location

1909 Wayzata Blvd
Wayzata, MN 55391-2047

Mailing address

1909 Wayzata Bouleverd
Wayzata, MN 55391-2047
Phone (952) 473-1261

Other identifiers 8

IdentifierTypeStateIssuer
123345900MedicaidMN
221545400MedicaidMN
318343200MedicaidMN
033045100MedicaidMN
013345100MedicaidMN
656726600MedicaidMN
483545000MedicaidMN
713721400MedicaidMN

Other names 1

  • HAMMER Other name

National Provider Directory

National Provider Directory
Tax ID family
Hammer3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1811919996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 WAYZATA BOULEVERD",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912047",
            "telephone_number": "952-473-1261",
            "fax_number": "952-473-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 WAYZATA BLVD",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912047",
            "telephone_number": "952-473-1261",
            "fax_number": "952-473-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMMER RESIDENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "ESTREM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "952-277-2422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123345900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221545400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318343200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033045100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013345100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "656726600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483545000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713721400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAMMER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.