NPIMap

Organization Active NPI

Self Regional Healthcare

Doing business as Lakelands Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Abbeville, SC
National Provider Identifier
1083488183
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SELF REGIONAL HEALTHCARE
Doing business as
Lakelands Nursing and Rehabilitation Center
Practice address
83 Thomson Cir
Abbeville, SC 29620-5652
Phone
(864) 366-5122
Fax
(864) 366-6123
NPI assigned
Nov 8, 2023
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Matthew Tolbert Logan
Title
President and Ceo
Phone
(864) 725-4780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

83 Thomson Cir
Abbeville, SC 29620-5652

Mailing address

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-5168

Other names 1

  • Lakelands Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240301003289 SC Part A Provider - Skilled Nursing Facility 4082527742 Practice locations: Abbeville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083488183. Details of each certification follow.

Skilled nursing facility certification: CCN 425057

Legal name
SELF REGIONAL HEALTHCARE
Doing business as
LAKELANDS NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 15, 1968
Last certification
Apr 17, 2025
Beds
69
Ownership / control type
County
Organization structure
OtherNon-profit
Incorporated
Sep 6, 1951 in SC
Enrollment address
83 Thomson Cir
Abbeville, SC 29620-5652
Nursing home name
LAKELANDS NURSING AND REHABILITATION CENTER

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakelands Nursing And Rehabilitation CenterCCN 425057 · All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jul 15, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6943.0 residents per day on average

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
42D0252635Lakelands Nursing and Rehabilitation Center83 Thomson Circle, Abbeville, SC 29620Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Self Regional Healthcar49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Matthew T Logan Individual Corporate OfficerPresident and Ceo Jan 1, 2024
Operational/Managerial ControlPresident and Ceo Jan 1, 2024
Trustee of the SNF Jan 1, 2024
Adp of the SNF Jan 1, 2024
Direct Ownership Interest Jan 1, 2024 50%
Keith a Scott Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Clint J Stewart Individual Corporate OfficerVP & Cfo Oct 21, 2024
Trustee of the SNF Oct 21, 2024
Adp of the SNF Oct 21, 2024
Direct Ownership Interest Oct 21, 2024 50%
Lisa Stewart Individual Operational/Managerial Control Mar 1, 2026
Adp of the SNF Mar 1, 2026

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Self Regional HealthcareGreenwood, SC, CCN 420071 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2025
Abbeville Area Medical CenterAbbeville, SC, CCN 421301 Hospital Operational/Managerial Control (100%) Oct 1, 2023
Edgefield County Healthcare an Affiliate of Self Regional HealthcareEdgefield, SC, CCN 421304 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Self Regional Healthcare PartnersEdgefield, SC, CCN 42Z304 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Abbeville Hospital Swingbed UnitAbbeville, SC, CCN 42Z301 Hospital Operational/Managerial Control (100%) Oct 1, 2023
Abbeville Area Healthcare CenterAbbeville, SC, CCN 423451 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2023
Due West Family MedicineDue West, SC, CCN 423453 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2023
Edgefield Medical CenterEdgefield, SC, CCN 423436 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Family Healthcare North SaludaSaluda, SC, CCN 873806 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 27, 2009
Self Medical Center JohnstonJohnston, SC, CCN 428515 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1083488183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463860",
            "telephone_number": "864-725-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 THOMSON CIR",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205652",
            "telephone_number": "864-366-5122",
            "fax_number": "864-366-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TOLBERT",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "864-725-4780"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakelands Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abbeville, SC

Sources for this page

Verify at the official NPI Registry.