EDGEWOOD MANOR
NPI 1164416509
Skilled Nursing Facility in Raytown, MO

Active since August 31, 2005
11900 JESSICA LN, RAYTOWN, MO 64138(816) 358-7858(816) 353-1514 Get Directions Write a Review

NPPES record last updated: October 7, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edgewood Manor NPPES

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

EDGEWOOD MANOR (NPI 1164416509) is a healthcare organization registered as a skilled nursing facility in Raytown, Missouri and active in the NPI registry since August 2005. The organization lists Carla Brooks, Cfo, as its authorized official.

NPPES Registry Identity

NPI1164416509
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameDEACONESS LONG TERM CARE OF MISSOURI, INC
Location Address11900 JESSICA LNRaytown, MO 64138-2649
Mailing Address440 Lafayette Ave, Suite 400Cincinnati, OH 45220-1022 · (513) 487-3600 · Fax (513) 487-3653
Fax(816) 353-1514
Organization SubpartNo
Authorized OfficialCarla BrooksCfo · (513) 487-3600
Enumeration DateAugust 31, 2005
Last NPPES UpdateOctober 7, 2008
NPI 1164416509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MO · 029538
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.
11900 JESSICA LN, Raytown, MO 64138

Other Names 1

Doing Business AsEdgewood Manor

Other Identifiers 6

Other90399-010MO · Blue Shield
Other90399-010MO · Blue Cross
Other5397477MO · Aetna
Other262783806MO · Pcare Provider #
Medicare ID-Type Unspecified265425MO · Medicare #
Medicaid102783800MO

Other Providers at the Same Location NPPES 11

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

Skilled Nursing Facility
11900 JESSICA LN
RAYTOWN, MO 64138
Physical Therapist
11900 JESSICA LN
RAYTOWN, MO 64138
Occupational Therapy Assistant
11900 JESSICA LN
RAYTOWN, MO 64138
Skilled Nursing Facility
11900 JESSICA LN
RAYTOWN, MO 64138
Skilled Nursing Facility
11900 JESSICA LN
RAYTOWN, MO 64138
Speech-Language Pathologist
11900 JESSICA LN
RAYTOWN, MO 64138
Skilled Nursing Facility
11900 JESSICA LN
RAYTOWN, MO 64138
Skilled Nursing Facility
11900 JESSICA LN
RAYTOWN, MO 64138

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 Deaconess Long Term Care Of Missouri, Inc's NPI number?

The NPI number for Deaconess Long Term Care Of Missouri, Inc is 1164416509. It was assigned to this organization in the NPPES registry on August 31, 2005. The provider is doing business as Edgewood Manor.

Where is Deaconess Long Term Care Of Missouri, Inc located?

Deaconess Long Term Care Of Missouri, Inc is located at 11900 Jessica Ln, Raytown, MO 64138. The listed phone number is (816) 358-7858.

What is Deaconess Long Term Care Of Missouri, Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Deaconess Long Term Care Of Missouri, Inc was last updated on October 7, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.