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MANOR ST JOSEPH
NPI 1174938773
Nursing Facility/Intermediate Care Facility in Edgeley, ND

Active since June 23, 2014CLIA 35D0408766 · Waiver
404 4TH AVE, EDGELEY, ND 58433(701) 493-2477 Get Directions Write a Review

NPPES record last updated: June 23, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Manor St Joseph NPPES

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

MANOR ST JOSEPH (NPI 1174938773) is a healthcare organization registered as a nursing facility/intermediate care facility in Edgeley, North Dakota and active in the NPI registry since June 2014. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Tammy Jangula, Administrator, as its authorized official.

NPPES Registry Identity

NPI1174938773
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameMANOR ST JOSEPH
Location Address404 4TH AVEEdgeley, ND 58433-7417
Mailing Address404 4th AveEdgeley, ND 58433-7417
Phone(701) 493-2477
Organization SubpartNo
Authorized OfficialTammy JangulaAdministrator · (701) 493-2477
Enumeration DateJune 23, 2014
✔ NPI 1174938773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in ND · 8009
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
404 4TH AVE, Edgeley, ND 58433
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Other Identifiers 1

Medicaid30709ND

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 35D0408766

Manor St Joseph · Edgeley, ND
Active · expires Aug 31, 2026
CLIA Number35D0408766
Laboratory TypeOther
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTammy A. Jangula
Laboratory Phone(701) 493-2477
Laboratory LocationManor St JosephP O Box 305, Edgeley, ND 58433
CLIA data matches this NPI record on: 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 Manor St Joseph's NPI number?

The NPI number for Manor St Joseph is 1174938773. It was assigned to this organization in the NPPES registry on June 23, 2014.

Where is Manor St Joseph located?

Manor St Joseph is located at 404 4th Ave, Edgeley, ND 58433. The listed phone number is (701) 493-2477.

What is Manor St Joseph's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Manor St Joseph hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D0408766) is associated with this NPI, valid through August 31, 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 Manor St Joseph was last updated on June 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.