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EDGEWOOD JAMESTOWN,LLC
NPI 1891241139
Assisted Living Facility in Grand Forks, ND

Active since August 28, 2016CLIA 35D2115984 · Waiver
322 DEMERS AVE, SUITE 500, GRAND FORKS, ND 58201(701) 757-5465 Get Directions Write a Review

NPPES record last updated: August 28, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edgewood Jamestown,llc NPPES

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

EDGEWOOD JAMESTOWN,LLC (NPI 1891241139) is a healthcare organization registered as an assisted living facility in Grand Forks, North Dakota and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through July 17, 2028 and lists Rex Carlson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1891241139
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD JAMESTOWN,LLC
Location Address322 DEMERS AVE, SUITE 500Grand Forks, ND 58201-4754
Mailing Address1104 25th Street SwJamestown, ND 58401 · (701) 757-5465 · Fax (701) 738-2001
Phone(701) 757-5465
Organization SubpartNo
Authorized OfficialRex CarlsonCfo · (701) 757-5463
Enumeration DateAugust 28, 2016
✔ NPI 1891241139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
322 DEMERS AVE, Grand Forks, ND 58201
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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 35D2115984

Edgewood Jamestown, LLC · Jamestown, ND
Active · expires Jul 17, 2028
CLIA Number35D2115984
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 18, 2026
Certificate Expiration DateJuly 17, 2028
Laboratory DirectorSarah Kelly
Laboratory Phone(701) 952-8750
Laboratory LocationEdgewood Jamestown, LLC1104 25th St SW, Jamestown, ND 58401
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

EDGEWOOD SARTELL LLC
Assisted Living Facility
322 DEMERS AVE, SUITE 500
GRAND FORKS, ND 58201
Grand Forks County (701) 757-5412
EDGEWOOD MANAGEMENT GROUP
Home Health
322 DEMERS AVE, SUITE 500
GRAND FORKS, ND 58201
Grand Forks 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 Jamestown,llc's NPI number?

The NPI number for Edgewood Jamestown,llc is 1891241139. It was assigned to this organization in the NPPES registry on August 28, 2016.

Where is Edgewood Jamestown,llc located?

Edgewood Jamestown,llc is located at 322 Demers Ave Suite 500, Grand Forks, ND 58201. The listed phone number is (701) 757-5465.

What is Edgewood Jamestown,llc's specialty?

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

Does Edgewood Jamestown,llc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2115984) is associated with this NPI, valid through July 17, 2028. 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 Jamestown,llc was last updated on August 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.