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Organization Active NPI

Edgewood Greenleaf Sioux Falls LLC

  • Assisted Living Facility
  • Sioux Falls, SD
National Provider Identifier
1992093389
Registry record updated Jul 19, 2011
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Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
47882 Issued in SD
Legal business name
EDGEWOOD GREENLEAF SIOUX FALLS LLC
Practice address
3409 E. 5TH St.
Sioux Falls, SD 57103-1235
Phone
(605) 275-0074
Fax
(605) 275-0076
NPI assigned
Jul 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Authorized official

Name
Mr. Ron Whetter
Title
VP of Budge/Finance
Phone
(701) 738-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 47882 SD Primary

Addresses

Primary practice location

3409 E. 5TH St.
Sioux Falls, SD 57103-1235

Mailing address

3409 E. 5TH St.
Sioux Falls, SD 57103-1235
Phone (605) 275-0074

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1992093389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 E. 5TH ST.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031235",
            "telephone_number": "605-275-0074",
            "fax_number": "605-275-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 E. 5TH ST.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031235",
            "telephone_number": "605-275-0074",
            "fax_number": "605-275-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD GREENLEAF SIOUX FALLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "WHETTER",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "VP OF BUDGE/FINANCE",
        "authorized_official_telephone_number": "701-738-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "47882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.