NPIMap

Organization Active NPI

Rehab Center of Cheraw LLC

Doing business as Rehab Center of Cheraw

  • Skilled Nursing Facility
  • Cheraw, SC
National Provider Identifier
1164815312
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
REHAB CENTER OF CHERAW LLC
Doing business as
Rehab Center of Cheraw
Practice address
1150 State Rd
Cheraw, SC 29520-2048
Phone
(843) 537-2060
Fax
(843) 537-3676
NPI assigned
Mar 12, 2015
Last updated
Jan 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Shannon Bennett
Title
President
Phone
(843) 537-2060

Specialties & licenses 1

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

Addresses

Primary practice location

1150 State Rd
Cheraw, SC 29520-2048

Mailing address

1150 State Rd
Cheraw, SC 29520-2048
Phone (843) 537-2060

Other identifiers 1

IdentifierTypeStateIssuer
NF1058MedicaidSC

Other names 1

  • Rehab Center of Cheraw Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625002064 SC Part A Provider - Skilled Nursing Facility 7416268867 Practice locations: Cheraw, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164815312. Details of each certification follow.

Skilled nursing facility certification: CCN 425302

Legal name
REHAB CENTER OF CHERAW LLC
Doing business as
REHAB CENTER OF CHERAW
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 22, 1991
Last certification
May 6, 2025
Beds
104
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 3, 2015 in DE
Enrollment address
1150 State Rd
Cheraw, SC 29520-2048
Nursing home name
REHAB CENTER OF CHERAW
Affiliated entity
FUNDAMENTAL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rehab Center of CherawCCN 425302 · All quality measures
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 22, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10499.5 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Special focus status
SFF
Penalties (3 years)
5Fines totaling $64,075

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
42D0916501Rehab Center of Cheraw1150 State Road, PO Box 1329, Cheraw, SC 29520Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory

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, Sparks, MD LLC 5% Or Greater Direct Ownership Interest Jan 14, 2015 100%
Murray Forman Individual 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%
Grace Villafranca Individual Corporate OfficerPresident Sep 9, 2019
W-2 Managing EmployeeAdministrator/President Sep 9, 2019
Thi of Baltimore, Inc. Organization, Sparks, MD For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2007 100%
Hunt Valley Holdings LLC Organization, Sparks Glencoe, MD LLC 5% Or Greater Indirect Ownership Interest Feb 9, 2010 100%

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 2

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": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1164815312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 STATE RD",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295202048",
            "telephone_number": "843-537-2060",
            "fax_number": "843-537-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE RD",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295202048",
            "telephone_number": "843-537-2060",
            "fax_number": "843-537-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB CENTER OF CHERAW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-537-2060"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NF1058",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab Center of Cheraw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.