Organization Active NPI

Laurel Baye Healthcare of Orangeburg, LLC

  • Skilled Nursing Facility
  • Orangeburg, SC
National Provider Identifier
1053309757
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF- 858 Issued in SC
Legal business name
LAUREL BAYE HEALTHCARE OF ORANGEBURG, LLC
Practice address
575 Stonewall Jackson Blvd
Orangeburg, SC 29115-7250
Phone
(803) 534-7771
NPI assigned
Oct 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Authorized official

Name
Tom Tiller
Title
Cfo
Phone
(843) 216-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCF- 858 SC Primary

Addresses

Primary practice location

575 Stonewall Jackson Blvd
Orangeburg, SC 29115-7250

Mailing address

575 Stonewall Jackson Blvd
Orangeburg, SC 29115-7250
Phone (803) 534-7771

Other identifiers 1

IdentifierTypeStateIssuer
0858NFMedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1053309757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 STONEWALL JACKSON BLVD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291157250",
            "telephone_number": "803-534-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 STONEWALL JACKSON BLVD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291157250",
            "telephone_number": "803-534-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL BAYE HEALTHCARE OF ORANGEBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "TILLER",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-216-6800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF- 858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.