Phem, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PHEM, LLC

Doing business as

Edgewood Manor Nursing Home

Practice address

11900 Jessica LN
Raytown, MO 64138-2649

Phone

(816) 358-7858

NPI assigned

Nov 9, 2010

Last updated

Mar 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Klein

Title

Manager

Phone

(847) 329-4100

Specialties & licenses 2

Addresses

Other names 1

• Edgewood Manor Nursing Home Doing business as

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1851692636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7444 LONG AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 JESSICA LN",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382649",
            "telephone_number": "816-358-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-329-4100"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Willie Lee Parker III, DPT
• Michael Eugene Patterson, LPC
• Delia Ana Pearl
• Jessica Peavler
• Personal Care Dental Group LLC
• Joseph Robert Pleasant, DDS
• Anna Pomeroy, LMSW
• Delainey Pospichal
• Premise Health of Missouri Medical PC (Raytown Schools)
• Preveycare LLC

• Skilled Nursing Facility in Raytown, MO
• Providers in Raytown, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.