EDGEWOOD VISTA (NPI# 1356494520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356494520 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD VISTA |
| Practice Address |
14890 Beaver Dam Rd Brainerd MN 56401-6019 |
| Mailing Address |
Po Box 13336 Grand Forks ND 58208-3336 |
| Practice Telephone | 2188283691 |
| Mailing Fax Number | 7017382001 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRETT WILKENING (BILLING) |
| Authorized Official Telephone | 7017382000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 332114 | MN | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245383462 | Edgewood Vista | Assisted Living Facility | 1225 Wicks Ln, Billings, MT 59105-4417 | 2007-01-19 |
| 1285787481 | Edgewood Vista | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 2007-01-19 |
| 1366595597 | Edgewood Vista | Assisted Living Facility | 2815 Palmer St, Missoula, MT 59808-1643 | 2007-01-19 |
| 1790838977 | Edgewood Vista | Assisted Living Facility | 608 5th Ave Nw, East Grand Forks, MN 56721-1738 | 2007-01-19 |
| 1720131931 | Edgewood Vista | Assisted Living Facility | 1011 Cardinal Dr, Belgrade, MT 59714-8373 | 2007-01-19 |
| 1407909633 | Edgewood Vista | Assisted Living Facility | 141 Interstate Ln, Kalispell, MT 59901-2877 | 2007-01-19 |
| 1982757175 | Edgewood Vista | Assisted Living Facility | 4195 Westberg Rd, Hermantown, MN 55811-3916 | 2007-01-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EDGEWOOD VISTA, LLC | 21708 Se 245th St, Maple Valley, WA 98038 |
| Street Address |
14890 BEAVER DAM RD |
| City | BRAINERD |
| State | MN |
| Zip Code | 56401-6019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831662154 | Kristen Elliott | Speech-Language Pathologist | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2019-01-09 |
| 1225506413 | Laura Melin | Physical Therapist | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2018-11-06 |
| 1841775194 | Caringedge Hospice of Brainerd | Hospice Care, Community Based | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2018-10-02 |
| 1225513674 | Caringedge Healthcare of Brainerd | Home Health | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2018-10-02 |
| 1912212820 | Laura Amundson | Occupational Therapist | 14890 Beaver Dam Rd, Brainerd, MN 56401 | 2010-08-16 |
| 1205010147 | Edgewood Brainerd Senior Living LLC | Assisted Living Facility | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2007-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
| 1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
| 1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
| 1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
| 1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
| Find all providers in zip 56401 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790103943 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 1953 S 7th St, Brainerd, MN 56401-4575 | 2014-04-04 |
| 1609294859 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 200 Buffalo Hills Ln, Brainerd, MN 56401-4555 | 2014-04-04 |
| 1629176383 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2509 Greenwood St Sw, Brainerd, MN 56401-8340 | 2006-09-20 |
| 1013011253 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2517 Greenwood St Sw, Brainerd, MN 56401-8340 | 2006-09-08 |
| 1487757852 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2501 Greenwood St Sw, Brainerd, MN 56401-8340 | 2006-09-07 |
| 1205010147 | Edgewood Brainerd Senior Living LLC | Assisted Living Facility | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2007-12-27 |
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|---|---|---|---|---|
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| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
| 1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| 1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
| 1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
| 1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
| 1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.