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WEDGEWOOD NURSING HOME
NPI 1174575625
Skilled Nursing Facility in Fort Worth, TX

Active since May 16, 2006CLIA 45D0683080 · Waiver
6621 DAN DANCIGER RD, FORT WORTH, TX 76133(817) 292-6330(817) 346-7980 Get Directions Write a Review

NPPES record last updated: October 30, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wedgewood Nursing Home NPPES

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

WEDGEWOOD NURSING HOME (NPI 1174575625) is a healthcare organization registered as a skilled nursing facility in Fort Worth, Texas and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Peter J Licari, President Of General Partner, as its authorized official.

NPPES Registry Identity

NPI1174575625
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWEDGEWOOD NURSING HOME, L.P.
Location Address6621 DAN DANCIGER RDFort Worth, TX 76133-4905
Mailing Address200 Dryden Rd EDresher, PA 19025-1048 · (215) 441-7700 · Fax (215) 441-4255
Phone(817) 292-6330
Fax(817) 346-7980
Organization SubpartNo
Authorized OfficialPeter J LicariPresident Of General Partner · (215) 441-7700
Enumeration DateMay 16, 2006
Last NPPES UpdateOctober 30, 2007
✔ NPI 1174575625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in TX · 115374
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.
Also ListedDurable Medical Equipment & Medical Supplies · Nursing Facility SuppliesTaxonomy 332BN1400X · License 115374 (TX)
Also ListedDurable Medical Equipment & Medical Supplies · Parenteral & Enteral NutritionTaxonomy 332BP3500X · License 115374 (TX)
6621 DAN DANCIGER RD, Fort Worth, TX 76133
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Other Names 1

Doing Business AsWedgewood Nursing Home

Other Identifiers 3

Medicare OSCAR/certification455572TX
Medicare NSC4531650001TX
Medicaid004960TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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 45D0683080

Wedgewood Nursing Home · Fort Worth, TX
Active · expires Aug 31, 2026
CLIA Number45D0683080
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKaren Kiechler
Laboratory Phone(817) 292-6330
Laboratory LocationWedgewood Nursing Home6621 Dan Danciger Road, Fort Worth, TX 76133
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 4

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

WEDGEWOOD SNF LLC
Skilled Nursing Facility
6621 DAN DANCIGER RD
FORT WORTH, TX 76133
Tarrant County (817) 292-6330
PALO PINTO COUNTY HOSPITAL DISTRICT
Skilled Nursing Facility
6621 DAN DANCIGER RD
FORT WORTH, TX 76133
Tarrant County (817) 292-6330
MRS. TAMARA BETH ALEXANDER PT
Physical Therapist
6621 DAN DANCIGER RD
FORT WORTH, TX 76133
Tarrant County (817) 292-6330
DILLON SMITH PT, DPT
Physical Therapist
6621 DAN DANCIGER RD
FORT WORTH, TX 76133
Tarrant County (979) 268-2462

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 Wedgewood Nursing Home, L.P.'s NPI number?

The NPI number for Wedgewood Nursing Home, L.P. is 1174575625. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Wedgewood Nursing Home.

Where is Wedgewood Nursing Home, L.P. located?

Wedgewood Nursing Home, L.P. is located at 6621 Dan Danciger Rd, Fort Worth, TX 76133. The listed phone number is (817) 292-6330.

What is Wedgewood Nursing Home, L.P.'s specialty?

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

Does Wedgewood Nursing Home, L.P. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0683080) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wedgewood Nursing Home, L.P. accept?

Health plans from UnitedHealthcare list Wedgewood Nursing Home, L.P. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wedgewood Nursing Home, L.P. was last updated on October 30, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.