NPIMap

Organization Active NPI

Edina Care Residence

  • Assisted Living Facility
  • Edina, MN
National Provider Identifier
1992877880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
21434 Issued in MN
Legal business name
EDINA CARE RESIDENCE
Practice address
6802 Dovre Dr
Edina, MN 55436-1715
Phone
(952) 988-9900
Fax
(952) 988-0061
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Marcia Dooner
Title
Executive Director
Phone
(763) 550-1774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 21434 MN Primary

Addresses

Primary practice location

6802 Dovre Dr
Edina, MN 55436-1715

Mailing address

4205 Lancaster LN N
Suite 109
Plymouth, MN 55441-1700

National Provider Directory

National Provider Directory
Tax ID family
Edina Care Residence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992877880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N",
            "address_2": "SUITE 109",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 DOVRE DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361715",
            "telephone_number": "952-988-9900",
            "fax_number": "952-988-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDINA CARE RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOONER",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "763-550-1774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "21434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.