EDGEWOOD MANOR OF WELLSTON LLC (NPI# 1477071371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477071371 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD MANOR OF WELLSTON LLC |
| Other Organization Name | EDGEWOOD MANOR OF WELLSTON |
| Practice Address |
405 North Park Avenue Wellston OH 45692 |
| Mailing Address |
1535 Rockaway Pkwy Brooklyn NY 11236-4001 |
| Practice Telephone | 7403845611 |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-08-31 |
| Authorized Official Name | ALEXANDER SHERMAN (MANAGING MEMBER) |
| Authorized Official Telephone | 7186888760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ODH HOME NUMBER | 1225N | 01 |
| Other Name | Type Code |
|---|---|
| Edgewood Manor of Wellston | Doing Business As Name - Organization |
| Street Address |
405 NORTH PARK AVENUE |
| City | WELLSTON |
| State | OH |
| Zip Code | 45692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720327067 | Laura R Chapman | Student in an Organized Health Care Education/Training Program | 405 North Park Avenue, Wellston, OH 45692 | 2013-02-06 |
| 1770823247 | Amanda N Massie | Occupational Therapy Assistant | 405 North Park Avenue, Wellston, OH 45692 | 2013-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190803 | Courtney Kincaid | Speech-Language Pathologist | 405 N Park Avenue, Wellston, OH 45692 | 2017-08-18 |
| 1154728905 | Kelly Newell | Health Educator | 519 Cheatwood Rd, Wellston, OH 45692 | 2014-11-21 |
| 1104167998 | Denise Rice | Occupational Therapy Assistant | 405 North Park Ave, Wellston, OH 45692 | 2013-03-05 |
| 1992016828 | Hands On Care Respiratory and Oxygen | Respiratory Therapist, Certified | 6200 St Rt 327, Jackson, OH 45692 | 2010-06-25 |
| 1154409357 | Nicole Lynn Wallis | Licensed Practical Nurse | 421 East 1st Street, Wellston, OH 45692 | 2006-11-02 |
| 1982242160 | Micah Erin Glenn | Nurse Practitioner | 405 N Park Ave, Wellston, OH 45692 | 2019-12-18 |
| 1659729267 | Erica Squires | Occupational Therapist | 405 North Park Ave, Wellston, OH 45692 | 2016-05-25 |
| 1720107576 | James Lee Phillips | Dentist | 22 North Ohio Avenue, Wellston, OH 45692-0266 | 2007-03-29 |
| 1942242409 | Tandem Healthcare of Wellston, Inc. | Skilled Nursing Facility | 405 N Park Ave, Wellston, OH 45692-1111 | 2006-06-11 |
| 1225042070 | Wellston Facility Operations, LLC | Skilled Nursing Facility | 405 N Park Ave, Wellston, OH 45692-1111 | 2006-07-28 |
| Find all providers in zip 45692 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679930440 | Genesis Healthcare | Skilled Nursing Facility | 19948 State Route 93, Wellston, OH 45692-9048 | 2016-01-25 |
| 1942242409 | Tandem Healthcare of Wellston, Inc. | Skilled Nursing Facility | 405 N Park Ave, Wellston, OH 45692-1111 | 2006-06-11 |
| 1114368347 | Patrice Helen Smith | Skilled Nursing Facility | 405 North Park Ave, Wellston, OH 45692-1930 | 2013-07-16 |
| 1225042070 | Wellston Facility Operations, LLC | Skilled Nursing Facility | 405 N Park Ave, Wellston, OH 45692-1111 | 2006-07-28 |
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| 1255980876 | Ehcs Oakhill Properties, LLC | Skilled Nursing Facility | 4466 Lynnhaven Ave, Louisville, OH 44641-9513 | 2019-09-06 |
| 1083260988 | Trilogy Healthcare of Tiffin, LLC | Skilled Nursing Facility | 410 Fair Lane, Tiffin, OH 44883 | 2019-08-15 |
| 1427604321 | Trilogy Healthcare of Pickerington, LLC | Skilled Nursing Facility | 603 Diley Road, Pickerington, OH 43147 | 2019-08-15 |
| 1205482189 | Trilogy Healthcare of Franklin IIi, LLC | Skilled Nursing Facility | 7320 Smith's Mill Road, New Albany, OH 43054 | 2019-08-15 |
| 1972164713 | Cardinal Delaware, Inc. | Skilled Nursing Facility | 6975 Graphics Way, Lewis Center, OH 43035 | 2019-06-24 |
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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.