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EDENCREST AT BEAVERDALE
NPI 1427563022
Assisted Living Facility in Des Moines, IA

Active since December 06, 2017CLIA 16D2140809 · Waiver
3410 BEAVER AVE, DES MOINES, IA 50310(515) 777-5105(515) 777-1969 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 16, 2018, Dec 6, 2017 (2 updates tracked since 2017).

About Edencrest At Beaverdale NPPES

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

EDENCREST AT BEAVERDALE (NPI 1427563022) is a healthcare organization registered as an assisted living facility in Des Moines, Iowa and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through November 29, 2027 and lists Sam Patterson, Manager, as its authorized official.

NPPES Registry Identity

NPI1427563022
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDENCREST AT BEAVERDALE
Location Address3410 BEAVER AVEDes Moines, IA 50310-3271
Mailing Address3410 Beaver AveDes Moines, IA 50310-3271 · (515) 777-5105 · Fax (515) 777-1969
Phone(515) 777-5105
Fax(515) 777-1969
Organization SubpartYesParent: Beaverdale Senior Living, Llc
Authorized OfficialSam PattersonManager · (515) 777-5105
Enumeration DateDecember 6, 2017
Last NPPES UpdateJune 16, 20182 updates tracked since enumeration
✔ NPI 1427563022 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 IA · S0369
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.
3410 BEAVER AVE, Des Moines, IA 50310
Open in Google Maps ↗

Other Identifiers 1

OtherS0369IA · Iowa Department Of Inspections And Appeals

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 16D2140809

Edencrest At Beaverdale · Des Moines, IA
Active · expires Nov 29, 2027
CLIA Number16D2140809
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 30, 2025
Certificate Expiration DateNovember 29, 2027
Laboratory DirectorJaci Wilcox
Laboratory Phone(515) 777-5105
Laboratory LocationEdencrest At Beaverdale3410 Beaver Avenue, Des Moines, IA 50310
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

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

3410 BEAVER AVENUE OPCO LLC
Assisted Living Facility
3410 BEAVER AVE
DES MOINES, IA 50310
Polk County (515) 777-5105

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 Edencrest At Beaverdale's NPI number?

The NPI number for Edencrest At Beaverdale is 1427563022. It was assigned to this organization in the NPPES registry on December 6, 2017.

Where is Edencrest At Beaverdale located?

Edencrest At Beaverdale is located at 3410 Beaver Ave, Des Moines, IA 50310. The listed phone number is (515) 777-5105.

What is Edencrest At Beaverdale's specialty?

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

Does Edencrest At Beaverdale hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D2140809) is associated with this NPI, valid through November 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edencrest At Beaverdale was last updated on June 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.