Organization Active NPI

Community Services for the Aging, Inc.

  • Skilled Nursing Facility
  • Spartanburg, SC
National Provider Identifier
1063409811
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF149 Issued in SC
Legal business name
COMMUNITY SERVICES FOR THE AGING, INC.
Practice address
340 Cedar Springs Road
Spartanburg, SC 29302
Phone
(864) 582-4175
Fax
(864) 583-2310
NPI assigned
Oct 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Authorized official

Name
Mr. Wilson K. Dillard
Title
Administrator
Phone
(864) 582-4175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCF149 SC Primary

Addresses

Primary practice location

340 Cedar Springs Road
Spartanburg, SC 29302

Mailing address

340 Cedar Springs Road
Spartanburg, SC 29302
Phone (864) 582-4175

Other identifiers 1

IdentifierTypeStateIssuer
291168MedicaidSC

Other names 1

  • Mountainview Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210000249 SC Part A Provider - Skilled Nursing Facility 1759400542 Practice locations: Spartanburg, SC

Skilled nursing facility certification: CCN 425027

Legal name
COMMUNITY SERVICES FOR THE AGING, INC.
Doing business as
MOUNTAINVIEW NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 1, 1967
Last certification
Nov 23, 2024
Beds
132
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
May 29, 1954 in SC
Enrollment address
340 Cedar Springs Rd
Spartanburg, SC 29302-4637
Nursing home name
MOUNTAINVIEW NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mountainview Nursing HomeCCN 425027
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
132120.8 residents per day on average
Penalties (3 years)
3Fines totaling $15,324

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0722212Mountainview Nursing Home340 Cedar Springs Road, Spartanburg, SC 29302Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

340 Cedar Springs Rd
Spartanburg, SC 29302
Phone (864) 582-4175

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
E. Ralph Wessinger Individual Corporate OfficerComptroller Oct 9, 2012
Carol McCulloch Individual Corporate Director Jan 1, 2021
Community Services for the Aging, Inc. Organization, Spartanburg, SC 5% Or Greater Direct Ownership Interest Jul 1, 2010
Keith Sisk Individual Corporate Director Jan 1, 2021
Matthew Summey Individual Corporate Director Jan 1, 2021
Earl Miller Individual Corporate Director Jan 1, 2021
Brenda Shirley Individual Corporate Director Jul 1, 2010
Kevin Walters Individual Corporate Director Nov 22, 1988
Richard Burgess Individual Corporate Director Jan 1, 2021
Wilson Dillard Individual Corporate Director Jul 1, 2010
W-2 Managing Employee Jul 1, 2010
Cynthia Matthews Individual OtherAssistant Administrator Jan 1, 2021
Sam Feemster Individual Corporate Director Jan 1, 2021
Paul Burnett Individual Corporate Director Jul 1, 2010
Leon Derek Herring Individual Corporate Director Jan 1, 2021
Kelly Shippy-Gilbert Individual Corporate Director Jul 1, 2010

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1063409811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 CEDAR SPRINGS ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-582-4175",
            "fax_number": "864-583-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 CEDAR SPRINGS ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-582-4175",
            "fax_number": "864-583-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICES FOR THE AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "864-582-4175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291168",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountainview Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.