EDGEWOOD MANOR HEALTH CARE CENTER, L.L.C.
NPI 1467072280
Skilled Nursing Facility in Raytown, MO

Active since April 22, 2020CLIA 26D0444670 · Waiver
1/5
Overall Rating
11900 JESSICA LN, RAYTOWN, MO 64138(816) 358-7858(816) 356-7775 Get Directions Write a Review

NPPES record last updated: April 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edgewood Manor Health Care Center, L.l.c. NPPES

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

EDGEWOOD MANOR HEALTH CARE CENTER, L.L.C. (NPI 1467072280), doing business as Edgewood Manor Health Care Center, is a healthcare organization registered as a skilled nursing facility in Raytown, Missouri and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Richard J. Destefane, President, as its authorized official.

NPPES Registry Identity

NPI1467072280
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEDGEWOOD MANOR HEALTH CARE CENTER, L.L.C.
Location Address11900 JESSICA LNRaytown, MO 64138-2649
Mailing Address1869 Craig Park CtSaint Louis, MO 63146-4122 · (314) 543-3816 · Fax (314) 226-1736
Fax(816) 356-7775
Organization SubpartNo
Authorized OfficialRichard J. DestefanePresident · (314) 543-3816
Enumeration DateApril 22, 2020
NPPES CertifiedApril 22, 2020
NPI 1467072280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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 Health Care Center

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 26D0444670

Edgewood Manor Health Care Center · Raytown, MO
Active · expires Aug 31, 2026
CLIA Number26D0444670
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKimpton Hopkins
Laboratory Phone(314) 543-3816
Laboratory LocationEdgewood Manor Health Care Center11900 Jessica Lane, Raytown, MO 64138
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Edgewood Manor Health Care Center (CMS certification number 265425), from CMS Care Compare.

Edgewood Manor Health Care Center

Nursing home · Raytown, MO
1/5 CMS Overall Rating
OwnershipFor profit - Partnership
CMS Certification Number265425
Certified Beds91 beds76 residents per day on average
Medicare & Medicaid Participant SinceApril 12, 1990
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
201
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.04 · LPN 0.64 · RN 0.12
2.81 hrs per resident per day
Weekend Nurse Staffing
2.59 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
73%
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.
Facility-Reported Incidents
5
Substantiated Complaints
7
Infection-Control Citations
0
Fines
2 totaling $49,377.25
Medicare Payment Denials
1
Total Penalties
3
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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
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
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 Edgewood Manor Health Care Center, L.L.C.'s NPI number?

The NPI number for Edgewood Manor Health Care Center, L.L.C. is 1467072280. It was assigned to this organization in the NPPES registry on April 22, 2020. The provider is doing business as Edgewood Manor Health Care Center.

Where is Edgewood Manor Health Care Center, L.L.C. located?

Edgewood Manor Health Care Center, L.L.C. is located at 11900 Jessica Ln, Raytown, MO 64138. The listed phone number is (816) 358-7858.

What is Edgewood Manor Health Care Center, L.L.C.'s specialty?

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

Does Edgewood Manor Health Care Center, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0444670) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Edgewood Manor Health Care Center, L.L.C. a Medicare-certified nursing home?

Yes. Edgewood Manor Health Care Center is a Medicare-certified nursing home with 91 certified beds.

What quality rating does Edgewood Manor Health Care Center, L.L.C. have?

CMS rates Edgewood Manor Health Care Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Edgewood Manor Health Care Center, L.L.C. was last updated on April 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.