EDGEWOOD MANOR
NPI 1104076322
Skilled Nursing Facility in Texarkana, TX

Active since September 24, 2008CLIA 45D1059724 · Waiver
4925 ELIZABETH ST, TEXARKANA, TX 75503(903) 793-4645(903) 793-3956 Get Directions Write a Review

NPPES record last updated: July 30, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edgewood Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWOOD MANOR (NPI 1104076322) is a healthcare organization registered as a skilled nursing facility in Texarkana, Texas and active in the NPI registry since September 2008. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Jamie L Collier, Director Of Reimbursement, as its authorized official.

NPPES Registry Identity

NPI1104076322
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePINNACLE HEALTH FACILITIES XXVII LP
Location Address4925 ELIZABETH STTexarkana, TX 75503-2911
Mailing Address5420 W Plano PkwyPlano, TX 75093-4823 · (972) 931-3800 · Fax (972) 767-6222
Fax(903) 793-3956
Organization SubpartNo
Authorized OfficialJamie L CollierDirector Of Reimbursement · (972) 931-3800
Enumeration DateSeptember 24, 2008
Last NPPES UpdateJuly 30, 2015
NPI 1104076322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
4925 ELIZABETH ST, Texarkana, TX 75503

Other Names 1

Doing Business AsEdgewood Manor

Other Identifiers 2

Medicaid001016351TX
Medicare OSCAR/certification676069

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1059724

Edgewood Manor · Texarkana, TX
Active · expires Oct 4, 2026
CLIA Number45D1059724
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorMary Huntsman-Hartfield
Laboratory Phone(903) 793-4645
Laboratory LocationEdgewood Manor4925 Elizabeth St, Texarkana, TX 75503
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
4925 ELIZABETH ST
TEXARKANA, TX 75503
Skilled Nursing Facility
4925 ELIZABETH ST
TEXARKANA, TX 75503

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pinnacle Health Facilities Xxvii LP's NPI number?

The NPI number for Pinnacle Health Facilities Xxvii LP is 1104076322. It was assigned to this organization in the NPPES registry on September 24, 2008. The provider is doing business as Edgewood Manor.

Where is Pinnacle Health Facilities Xxvii LP located?

Pinnacle Health Facilities Xxvii LP is located at 4925 Elizabeth St, Texarkana, TX 75503. The listed phone number is (903) 793-4645.

What is Pinnacle Health Facilities Xxvii LP's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Pinnacle Health Facilities Xxvii LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1059724) is associated with this NPI, valid through October 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pinnacle Health Facilities Xxvii LP was last updated on July 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.