NPIMap

Organization Active NPI

Thi of South Carolina at Camp Care, LLC

Doing business as Lake Emory Post Acute Care

  • Skilled Nursing Facility
  • Inman, SC
National Provider Identifier
1154418333
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THI OF SOUTH CAROLINA AT CAMP CARE, LLC
Doing business as
Lake Emory Post Acute Care
Practice address
59 Blackstock Rd
Inman, SC 29349-1827
Phone
(864) 472-2028
Fax
(864) 472-6901
NPI assigned
Oct 7, 2006
Last updated
Sep 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Authorized official

Name
Wadette Cothran
Title
President
Phone
(864) 472-2028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

59 Blackstock Rd
Inman, SC 29349-1827

Mailing address

920 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other names 1

  • Lake Emory Post Acute Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713000134 SC Part A Provider - Skilled Nursing Facility 6709864085 Practice locations: Inman, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154418333. Details of each certification follow.

Skilled nursing facility certification: CCN 425303

Legal name
THI OF SOUTH CAROLINA AT CAMP CARE, LLC
Doing business as
LAKE EMORY POST ACUTE CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 15, 1991
Last certification
Jul 18, 2024
Beds
88
Ownership / control type
Corporation
Multi-facility organization
Fundamental
Organization structure
LLCProprietary
Incorporated
May 19, 2003 in DE
Enrollment address
59 Blackstock Rd
Inman, SC 29349-1827
Nursing home name
LAKE EMORY POST ACUTE CARE
Affiliated entity
FUNDAMENTAL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Emory Post Acute CareCCN 425303 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 15, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8885.1 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
3Fines totaling $27,147

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
42D0939938Lake Emory Post Acute Care59 Blackstock Road, Inman, SC 29349Certificate of waiverFeb 2, 2028

National Provider Directory

National Provider Directory

Locations

59 Blackstock Rd
Inman, SC 29349
Phone (864) 472-2028

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Thi of South Carolina, LLC Organization, Greenwood, SC For-profit 5% Or Greater Direct Ownership Interest Aug 30, 2003 100%
Murray Forman Individual 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%
Jeanette Blankenship Individual Corporate OfficerAdministrator President May 30, 2019
W-2 Managing EmployeeAdministrator May 30, 2019
Thi of Baltimore, Inc. Organization, Sparks, MD For-profit 5% Or Greater Indirect Ownership Interest Aug 30, 2003 100%
Hunt Valley Holdings LLC Organization, Sparks, MD For-profit 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%

Facilities with the same owner 40

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

View all 40

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": "1379462400000",
    "number": "1154418333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 BLACKSTOCK RD",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293491827",
            "telephone_number": "864-472-2028",
            "fax_number": "864-472-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF SOUTH CAROLINA AT CAMP CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "COTHRAN",
        "authorized_official_first_name": "WADETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-472-2028"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Emory Post Acute Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inman, SC

Sources for this page

Verify at the official NPI Registry.