NPIMap

Organization Active NPI

Lowcountry Nursing Group, LLC

Doing business as Interim Healthcare Hospice

  • Community Based Hospice Care Agency
  • Charleston, SC
National Provider Identifier
1043965114
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LOWCOUNTRY NURSING GROUP, LLC
Doing business as
Interim Healthcare Hospice
Practice address
3820 Faber Place Dr Ste 200
Charleston, SC 29405-8566
Phone
(843) 554-1410
Fax
(843) 554-1409
NPI assigned
Feb 17, 2022
Last updated
Feb 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
LOWCOUNTRY NURSING GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashlee Pittman, DPT
Title
Ceo
Phone
(843) 518-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

3820 Faber Place Dr Ste 200
Charleston, SC 29405-8566

Mailing address

3820 Faber Place Dr Ste 200
Charleston, SC 29405-8566
Phone (843) 554-1410

Other names 1

  • Interim Healthcare Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220628003789 SC Part A Provider - Hospice 9931107653 Practice locations: North Charleston, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043965114. Details of each certification follow.

Hospice certification: CCN 421646

Legal name
LOWCOUNTRY NURSING GROUP, LLC
Doing business as
INTERIM HEALTHCARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 20, 2022
Last certification
Sep 15, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Apr 1, 2006 in SC
Enrollment address
3820 Faber Place Dr
Ste 200
North Charleston, SC 29405-8566

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Interim Health Care Hospice of CharlestonCCN 421646 · All quality measures
Certified
Sep 20, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lowcounty Nursing Group6 organizations share this tax ID, including this one
Part of
Lowcounty Nursing Group

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ashlee Pittman Individual Operational/Managerial ControlCeo Apr 28, 2022 100%
Paula Tharp Individual 5% Or Greater Direct Ownership InterestCo-Owner Aug 22, 2014 40%
Robb Baker Individual 5% Or Greater Direct Ownership Interest Aug 22, 2014 20%
Dawn Costanzo Individual 5% Or Greater Direct Ownership InterestManaging Member Apr 1, 2006 40%
Corporate OfficerAdministrator Apr 28, 2022 100%
Julia H Saylors Individual Contracted Managing EmployeeMedical Director Jan 1, 2024
Brett McCoy Individual Corporate DirectorAdmininstrator Apr 1, 2024 100%
W-2 Managing EmployeeAdministrator Apr 1, 2024 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1043965114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 FABER PLACE DR STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294058566",
            "telephone_number": "843-554-1410",
            "fax_number": "843-554-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 FABER PLACE DR STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294058566",
            "telephone_number": "843-554-1410",
            "fax_number": "843-554-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY NURSING GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOWCOUNTRY NURSING GROUP, LLC",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-518-5437",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim Healthcare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.