Wedgewood Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2722301 Issued in NY

Legal business name

WEDGEWOOD NURSING HOME, INC.

Practice address

5 Church St
Spencerport, NY 14559-1343

Phone

(585) 352-4810

Fax

(585) 352-1032

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dennis L Mart

Title

Cfo

Phone

(585) 244-0410

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1811992944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 EAST AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072107",
            "telephone_number": "585-244-0410",
            "fax_number": "585-244-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CHURCH ST",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591343",
            "telephone_number": "585-352-4810",
            "fax_number": "585-352-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGEWOOD NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "MART",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-244-0410",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "2722301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474442",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.