Active NPI
Clarendon Memorial Hospital
Doing business as Pocotaligo Health and Rehab Center
- Skilled Nursing Facility
- Manning, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NCF737
- Legal business name
- CLARENDON MEMORIAL HOSPITAL
- Doing business as
- Pocotaligo Health and Rehab Center
- Practice address
- 3147 Sumter Hwy
Manning, SC 29102-9090 - Phone
- (803) 478-2323
- Fax
- (803) 478-2357
- NPI assigned
- Nov 7, 2005
- Last updated
- Feb 8, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Christie H Browder
- Title
- Cfo
- Phone
- (803) 433-2005
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NCF737 | SC | Primary |
Addresses
Primary practice location
3147 Sumter Hwy
Manning, SC 29102-9090
Mailing address
PO Box 1332
Manning, SC 29102-1332
Phone (803) 478-2323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0737NF | Medicaid | SC |
Other names 1
- Pocotaligo Health and Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061106000489 | SC | Part A Provider - Skilled Nursing Facility | 4082514948 | Practice locations: Manning, SC |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1003897125. Details of each certification follow.
Skilled nursing facility certification: CCN 425114
- Legal name
- CLARENDON MEMORIAL HOSPITAL
- Doing business as
- SOUTHERN SENIOR LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1978
- Last certification
- Jul 24, 2024
- Beds
- 88
- Ownership / control type
- Other Nonprofit
- Organization structure
- Other
- Enrollment address
- 3147 Sumter Hwy
Manning, SC 29102-9090 - Nursing home name
- POCOTALIGO RIVER HEALTH AND REHAB
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Lake Moultrie Health and Rehab Center
- Skilled Nursing Facility
- Saint Stephen, SC
- NPI 1043291263
4082514948
-
dba Lake Marion Health and Rehab Center
- Skilled Nursing Facility
- Summerton, SC
- NPI 1588645709
4082514948
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pocotaligo River Health And Rehab
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Jul 1, 1978
- Medicare certification status
- Active
- Certified beds
- 88
- Penalties (3 years)
- 2
National Provider Directory
National Provider Directory- Tax ID family
- Clarenoon Memorial Hosp
Other organizations with this tax ID 13
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Cypress Center Pharmacy
- Community/Retail Pharmacy
- Manning, SC
- NPI 1679618912
-
dba Lake Moultrie Health and Rehab Center
- Skilled Nursing Facility
- Saint Stephen, SC
- NPI 1043291263
-
dba Cypress Center LTC Pharmacy
- Long Term Care Pharmacy
- Manning, SC
- NPI 1093987091
-
dba Robert S Eagerton, Jr, MD Family Practice
- Rural Health Clinic/Center
- Manning, SC
- NPI 1336413681
-
dba Palmetto Primary Care
- Rural Health Clinic/Center
- Manning, SC
- NPI 1366521874
-
dba East Clarendon Medical Center
- Rural Health Clinic/Center
- Turbeville, SC
- NPI 1437238771
-
dba Lake Marion Health and Rehab Center
- Skilled Nursing Facility
- Summerton, SC
- NPI 1588645709
-
dba Manning Medicine and Palmetto Women's Healthcare
- Family Medicine Physician
- Manning, SC
- NPI 1700965217
-
dba Dr. J. Daulton DuBose Medical Center
- Rural Health Clinic/Center
- Summerton, SC
- NPI 1710293873
-
dba Clarendon Chronic Disease Center
- Specialist
- Manning, SC
- NPI 1891160693
-
- General Acute Care Hospital
- Manning, SC
- NPI 1891901500
-
- Ambulance
- Manning, SC
- NPI 1851595078
Networks
- SC HMO
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Christina Browder | Corporate Officer | Jul 12, 2016 | |
| Clarendon Memorial Hospital | 5% Or Greater Direct Ownership Interest | Sep 30, 2005 | |
| Mathew Stanley | Corporate Officer | Jun 9, 2022 | |
| Operational/Managerial Control | Jun 9, 2022 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Lake Moultrie Health and Rehab Center
- Skilled Nursing Facility
- Saint Stephen, SC
- NPI 1043291263
5% Or Greater Direct Ownership Interest
-
dba Lake Marion Health and Rehab Center
- Skilled Nursing Facility
- Summerton, SC
- NPI 1588645709
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Southern Senior Living | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Sep 30, 2005 |
| Southern Senior Living | Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Sep 30, 2005 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Lake Moultrie Health and Rehab Center
- Skilled Nursing Facility
- Saint Stephen, SC
- NPI 1043291263
5% Or Greater Direct Ownership Interest
-
dba Lake Marion Health and Rehab Center
- Skilled Nursing Facility
- Summerton, SC
- NPI 1588645709
5% Or Greater Direct Ownership Interest
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Lake Moultrie Health and Rehab Center
- Skilled Nursing Facility
- Saint Stephen, SC
- NPI 1043291263
Clarendon Memorial Hospital
-
dba Lake Marion Health and Rehab Center
- Skilled Nursing Facility
- Summerton, SC
- NPI 1588645709
Clarendon Memorial Hospital
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Sumter, SC
- NPI 1265418164
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644278400000",
"number": "1003897125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1332",
"city": "MANNING",
"state": "SC",
"postal_code": "291021332",
"telephone_number": "803-478-2323",
"fax_number": "803-478-2357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3147 SUMTER HWY",
"city": "MANNING",
"state": "SC",
"postal_code": "291029090",
"telephone_number": "803-478-2323",
"fax_number": "803-478-2357"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARENDON MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-07",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A",
"authorized_official_last_name": "BROWDER",
"authorized_official_first_name": "CHRISTIE",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "803-433-2005",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "SC",
"license": "NCF737",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0737NF",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pocotaligo Health and Rehab Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Manning, SC
- Clarendon County School District
- Clarendon Eye Center P a
- Clarendon Family Dentistry Inc
- Clarendon Health and Wellness Center
- Clarendon Hospital District (Cypress Center Pharmacy)
- Clarendon Memorial Hospital (Cypress Center LTC Pharmacy)
- Clarendon Memorial Hospital (Clarendon Pulmonary Associates)
- Clarendon Memorial Hospital (The Clarendon Clinic)
- Clarendon Memorial Hospital (Clarendon Pediatric Associates)
- Clarendon Memorial Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.