Edgewood Norfolk Senior Living

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

28D1059766 Issued in NE

Legal business name

EDGEWOOD NORFOLK SENIOR LIVING

Practice address

1109 Pasewalk Ave.
Norfolk, NE 68701-4916

Phone

(402) 371-0052

Fax

(402) 371-0053

NPI assigned

Apr 6, 2011

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, CPA

Title

Chief Financial Officer

Phone

(701) 738-2000

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1831488287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 PASEWALK AVE.",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014916",
            "telephone_number": "402-371-0052",
            "fax_number": "402-371-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 PASEWALK AVE.",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014916",
            "telephone_number": "402-371-0052",
            "fax_number": "402-371-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD NORFOLK SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "701-738-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NE",
            "license": "28D1059766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025292600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Eacker
• Patti J Eacker
• Ear, Nose & Throat Associates, P.C.
• April Ebeling
• Philip Eckstrom, M.D.
• Donald E Edwards, LADC
• Julie Ann Edwards
• Kathy J. Effle-Meyer, APRN
• Jorden M Ehly
• Christy Eich

• Alzheimer Center (Dementia Center) in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Alzheimer Center (Dementia Center) in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.