EDGEWOOD OMAHA SENIOR LIVING
NPI 1114216561
Alzheimer Center (Dementia Center) in Omaha, NE

Q: What is Edgewood Omaha Senior Living's NPI number?

The NPI number for Edgewood Omaha Senior Living is 1114216561. It was assigned to this organization in the NPPES registry on April 6, 2011.

Q: What is Edgewood Omaha Senior Living's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Active since April 06, 2011CLIA 28D1060340 · Waiver

17620 POPPLETON AVE., OMAHA, NE 68130(402) 333-5749(402) 697-3998 Get Directions Write a Review

NPPES record last updated: April 6, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Edgewood Omaha Senior Living NPPES

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

EDGEWOOD OMAHA SENIOR LIVING (NPI 1114216561) is a healthcare organization registered as an alzheimer center (dementia center) in Omaha, Nebraska and active in the NPI registry since April 2011. The organization holds a CLIA Waiver certificate valid through October 19, 2026 and lists Rex Carlson, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1114216561

Entity TypeOrganization

Primary Taxonomy311500000X

Legal Business NameEDGEWOOD OMAHA SENIOR LIVING

Location Address17620 POPPLETON AVE.Omaha, NE 68130-4614

Mailing Address17620 Poppleton Ave.Omaha, NE 68130-4614 · (402) 333-5749 · Fax (402) 697-3998

Phone(402) 333-5749

Fax(402) 697-3998

Organization SubpartNo

Authorized OfficialRex CarlsonChief Financial Officer · (701) 738-2000

Enumeration DateApril 6, 2011

✔ NPI 1114216561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities

Taxonomy Code311500000X

License✔ Licensed in NE · 2801060340

Definition

A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

17620 POPPLETON AVE., Omaha, NE 68130

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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 28D1060340

Edgewood Omaha Senior Living, LLC · Omaha, NE

Active · expires Oct 19, 2026

CLIA Number28D1060340

Laboratory TypeOther

Certificate Effective DateOctober 20, 2024

Certificate Expiration DateOctober 19, 2026

Laboratory DirectorMs. Alice T. Cross

Laboratory Phone(402) 333-5749

Laboratory LocationEdgewood Omaha Senior Living, LLC17620 Poppleton Avenue, Omaha, NE 68130

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Edgewood Omaha Senior Living's NPI number?

The NPI number for Edgewood Omaha Senior Living is 1114216561. It was assigned to this organization in the NPPES registry on April 6, 2011.

Where is Edgewood Omaha Senior Living located?

Edgewood Omaha Senior Living is located at 17620 Poppleton Ave., Omaha, NE 68130. The listed phone number is (402) 333-5749.

What is Edgewood Omaha Senior Living's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Edgewood Omaha Senior Living hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D1060340) is associated with this NPI, valid through October 19, 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 Edgewood Omaha Senior Living was last updated on April 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.