EDGEBROOK CARE CENTER NPI 1003893447

NPI Information

  • NPI: 1003893447
  • Provider Name: EDGEBROOK CARE CENTER
  • Classification: Skilled Nursing Facility - 314000000X
  • Entity Type: Organization
  • Address: 505 W TROSKY RD
    EDGERTON, MN
    ZIP 56128
  • Phone: (507) 442-7121

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NPI Details

EDGEBROOK CARE CENTER is a skilled nursing facility in Edgerton, MN. The provider is (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. EDGEBROOK CARE CENTER NPI is 1003893447. The provider is registered as an organization entity type.

The provider's business location address is:

505 W TROSKY RD
EDGERTON, MN
ZIP 56128-748
Phone: (507) 442-7121
Fax: (507) 442-3952

The provider's authorized official is John Doughty .
The authorized official title is Administrator and has the following contact phone number (507) 442-7121.

The enumeration date for this NPI number is 12/28/2005 and was last updated on 12/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332BN1400XDurable Medical Equipment & Medical SuppliesNursing Facility SuppliesNo
2332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionNo
3314000000XSkilled Nursing FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1767842800MEDICAIDMINNESOTA
2030824003OTHERMINNESOTAPRIME WEST
39508EDOTHERMINNESOTABCBS
47122565OTHERMINNESOTAEVERCARE-MEDICA
5245560MEDICARE OSCAR/CERTIFICATIONSOUTH DAKOTA
6NH0481OTHERMINNESOTAUCARE
70459540001MEDICARE NSCMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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