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EDGEWOOD SPRING CREEK USTICK, LLC
NPI 1225313737
Assisted Living Facility in Meridian, ID

Active since October 15, 2011CLIA 13D2195026 · Waiver
3165 MERIDIAN RD, MERIDIAN, ID 83646(208) 287-2064 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edgewood Spring Creek Ustick, Llc NPPES

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

EDGEWOOD SPRING CREEK USTICK, LLC (NPI 1225313737) is a healthcare organization registered as an assisted living facility in Meridian, Idaho and active in the NPI registry since October 2011. The organization holds a CLIA Waiver certificate valid through October 5, 2026 and lists John Dybwad, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1225313737
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD SPRING CREEK USTICK, LLC
Location Address3165 MERIDIAN RDMeridian, ID 83646
Mailing AddressPo Box 13238Grand Forks, ND 58208 · (701) 738-2000
Phone(208) 287-2064
Organization SubpartNo
Authorized OfficialJohn DybwadVp Of Finance · (701) 757-5422
Enumeration DateOctober 15, 2011
Last NPPES UpdateAugust 19, 2022
NPPES CertifiedAugust 19, 2022
✔ NPI 1225313737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in ID · RC1004
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3165 MERIDIAN RD, Meridian, ID 83646
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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 13D2195026

Edgewood Spring Creek Ustick LLC · Meridian, ID
Active · expires Oct 5, 2026
CLIA Number13D2195026
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 6, 2024
Certificate Expiration DateOctober 5, 2026
Laboratory DirectorAshley Checketts
Laboratory Phone(208) 287-2064
Laboratory LocationEdgewood Spring Creek Ustick LLC3165 N Meridian Rd, Meridian, ID 83646
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 Edgewood Spring Creek Ustick, LLC's NPI number?

The NPI number for Edgewood Spring Creek Ustick, LLC is 1225313737. It was assigned to this organization in the NPPES registry on October 15, 2011.

Where is Edgewood Spring Creek Ustick, LLC located?

Edgewood Spring Creek Ustick, LLC is located at 3165 Meridian Rd, Meridian, ID 83646. The listed phone number is (208) 287-2064.

What is Edgewood Spring Creek Ustick, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Edgewood Spring Creek Ustick, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2195026) is associated with this NPI, valid through October 5, 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 Spring Creek Ustick, LLC was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.