NPIMap

Organization Active NPI

Thi of South Carolina at Magnolia Place at Greenville, LLC

Doing business as Southpointe Healthcare and Rehabilitation

  • Skilled Nursing Facility
  • Greenville, SC
National Provider Identifier
1124115316
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THI OF SOUTH CAROLINA AT MAGNOLIA PLACE AT GREENVILLE, LLC
Doing business as
Southpointe Healthcare and Rehabilitation
Practice address
35 Southpointe Dr
Greenville, SC 29607-5956
Phone
(864) 288-1415
Fax
(864) 288-7271
NPI assigned
Oct 7, 2006
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Shannon Farthing
Title
President
Phone
(864) 288-1415

Specialties & licenses 1

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

Addresses

Primary practice location

35 Southpointe Dr
Greenville, SC 29607-5956

Mailing address

35 Southpointe Dr
Greenville, SC 29607-5956
Phone (864) 288-1415

Other identifiers 1

IdentifierTypeStateIssuer
0869NFMedicaidSC

Other names 1

  • Southpointe Healthcare and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000456 SC Part A Provider - Skilled Nursing Facility 5395722615 Practice locations: Greenville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124115316. Details of each certification follow.

Skilled nursing facility certification: CCN 425361

Legal name
THI OF SOUTH CAROLINA AT MAGNOLIA PLACE AT GREENVILLE, LLC
Doing business as
SOUTHPOINTE HEALTHCARE AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 10, 1998
Last certification
Mar 7, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Fundamental
Organization structure
LLCProprietary
Incorporated
May 19, 2003 in DE
Enrollment address
35 Southpointe Dr
Greenville, SC 29607-5956
Nursing home name
SOUTHPOINTE HEALTHCARE AND REHABILITATION
Affiliated entity
FUNDAMENTAL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southpointe Healthcare and RehabilitationCCN 425361 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 10, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120111.2 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Penalties (3 years)
1Fines totaling $14,433

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
42D0953411Southpointe Healthcare and Rehabilitation35 Southpointe Drive, Greenville, SC 29607Certificate of waiverNov 1, 2026

National Provider Directory

National Provider Directory

Locations

35 Southpointe Dr
Greenville, SC 29607
Phone (864) 288-1415

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Fundamental Clinical and Operational Services, LLC Organization, Sparks, MD LLC Adp of the SNF Aug 30, 2003
Thi of South Carolina, LLC Organization, Sparks, MD LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 30, 2003 100%
Operational/Managerial Control Aug 30, 2003
Murray Forman Individual 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%
Lisa Marie Forgione Individual Adp of the SNF May 1, 2021
Fundamental Administrative Services LLC Organization, Sparks, MD LLC Adp of the SNF Aug 30, 2003
Ravaun Carroll Individual Operational/Managerial Control Oct 15, 2025
Adp of the SNF Oct 15, 2025
Thi of Baltimore, Inc. Organization, Sparks, MD Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 30, 2003 100%
Hunt Valley Holdings LLC Organization, Sparks, MD LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 40

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 40

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": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1124115316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SOUTHPOINTE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075956",
            "telephone_number": "864-288-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SOUTHPOINTE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075956",
            "telephone_number": "864-288-1415",
            "fax_number": "864-288-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF SOUTH CAROLINA AT MAGNOLIA PLACE AT GREENVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "FARTHING",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-288-1415"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0869NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southpointe Healthcare and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.