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EDGEWOOD VISTA SENIOR LIVING INC
NPI 1548313992
Assisted Living Facility in Spearfish, SD

Active since January 19, 2007CLIA 43D1032894 · Waiver
540 FALCON CREST DR, SPEARFISH, SD 57783(605) 642-2977 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Edgewood Vista Senior Living Inc NPPES

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

EDGEWOOD VISTA SENIOR LIVING INC (NPI 1548313992) is a healthcare organization registered as an assisted living facility in Spearfish, South Dakota and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through October 31, 2026 and lists Ann M Wagner, Accounts Receivable Clerk, as its authorized official.

NPPES Registry Identity

NPI1548313992
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD VISTA SENIOR LIVING INC
Location Address540 FALCON CREST DRSpearfish, SD 57783-3255
Mailing AddressPo Box 13336, 2450 24th Ave S Suite 201Grand Forks, ND 58208-3336 · (701) 738-2000
Phone(605) 642-2977
Organization SubpartNo
Authorized OfficialAnn M WagnerAccounts Receivable Clerk · (701) 738-2000
Enumeration DateJanuary 19, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1548313992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Licenses✔ Licensed in SD · 11073✔ Licensed in SD · 49736
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.
Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License 49736 (SD), 11073 (SD)
540 FALCON CREST DR, Spearfish, SD 57783
Open in Google Maps ↗

Other Identifiers 1

Medicaid9570693SD

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 43D1032894

Edgewood Spearfish Senior Living LLC · Spearfish, SD
Active · expires Oct 31, 2026
CLIA Number43D1032894
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 1, 2024
Certificate Expiration DateOctober 31, 2026
Laboratory DirectorPamela Fickbohm
Laboratory Phone(605) 642-2977
Laboratory LocationEdgewood Spearfish Senior Living LLC540 Falcon Crest Drive, Spearfish, SD 57783
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

DEMING HAUGLAND DPT
Physical Therapist
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (605) 642-2977
MEGAN MARIE STRAIN
Occupational Therapist
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (605) 388-2487
HAYLEY MADLER FNP-C
Nurse Practitioner (Family)
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (701) 516-4637
HEIDI MARIE WILLIAMS I
Occupational Therapy Assistant
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (605) 642-2977
EDGEWOOD SPEARFISH SENIOR LIVING LLC
Assisted Living Facility
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (701) 738-2000
EDGEWOOD SPEARFISH SENIOR LIVING LLC
Assisted Living Facility (Assisted Living, Behavioral Disturbances)
540 FALCON CREST DR
SPEARFISH, SD 57783
Lawrence County (701) 738-2000

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 Vista Senior Living Inc's NPI number?

The NPI number for Edgewood Vista Senior Living Inc is 1548313992. It was assigned to this organization in the NPPES registry on January 19, 2007.

Where is Edgewood Vista Senior Living Inc located?

Edgewood Vista Senior Living Inc is located at 540 Falcon Crest Dr, Spearfish, SD 57783. The listed phone number is (605) 642-2977.

What is Edgewood Vista Senior Living Inc's specialty?

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

Does Edgewood Vista Senior Living Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 43D1032894) is associated with this NPI, valid through October 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 Edgewood Vista Senior Living Inc was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.