FMG 72ND Avenue West Washington LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG 72ND AVENUE WEST WASHINGTON LLC

Doing business as

Aldercrest Health & Rehabilitation Center

Practice address

21400 72ND Ave W
Edmonds, WA 98026-7702

Phone

(425) 775-1961

Fax

(425) 771-0116

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

David C. Keating

Title

Agent

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Aldercrest Health & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1932507225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WEST LEMON STREET",
            "address_2": "C/O FOCUS MANAGEMENT GROUP",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091103",
            "telephone_number": "813-281-0062",
            "fax_number": "812-281-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 72ND AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267702",
            "telephone_number": "425-775-1961",
            "fax_number": "425-771-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG 72ND AVENUE WEST WASHINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aldercrest Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anita Floresca, CCC-SLP, CLC
• Floresh Wellness
• Florez Adult Family Home
• Matthew Daniel Flugstad, D.D.S
• Dale Timothy Flynn, MSPA CCCA
• Julie Foerster
• Kathryn Trinh Fong, M.D.
• Darcy Silver Foral, M.D.
• Cheryl M Ford, LMHC
• Sally Forgette, ARNP

• Skilled Nursing Facility in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.