NPIMap

Organization Active NPI

Hartsville, LLC

Doing business as Carolina Pines Regional Medical Center

  • General Acute Care Hospital
  • Hartsville, SC
National Provider Identifier
1174500458
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
HARTSVILLE, LLC
Doing business as
Carolina Pines Regional Medical Center
Practice address
1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone
(843) 339-2100
Fax
(843) 339-4116
NPI assigned
Dec 28, 2005
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Johnetta Traylor
Title
Director
Phone
(502) 596-6063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X SC Primary
Certified Registered Nurse Anesthetist 367500000X

Addresses

Primary practice location

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710

Mailing address

680 S 4TH St
Louisville, KY 40202-2407

Other identifiers 3

IdentifierTypeStateIssuer
274290MedicaidSC
GP2679MedicaidSC
340464MedicaidSC

Other names 1

  • Carolina Pines Regional Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carolinapinesregmedcen@capella.medalliesdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050518000582 SC Part B Supplier - Clinic/Group Practice 9638110836 Receives reassigned benefits from 8 practitioners
Practice locations: Hartsville, SC
O20060120000079 SC Part A Provider - Hospital 9638110836 Practice locations: Hartsville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174500458. Details of each certification follow.

Hospital certification: CCN 420010

Legal name
HARTSVILLE LLC
Doing business as
CAROLINA PINES REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 17, 2021
Beds
116
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Other Hospital Practice Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Carolina Pines Regional Medical CenterCCN 420010 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Hartsville Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

701 Medical Park Dr
Ste 100
Hartsville, SC 29550
Phone (843) 339-4797

701 Medical Park Dr
Ste 109
Hartsville, SC 29550
Phone (843) 339-4151

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Carolina Pines Holdings LLC Organization, Louisville, KY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 31, 2014 98.7%
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, Management services company, For-profit Operational/Managerial Control Dec 23, 2021 100%
Brian Craven Individual Corporate OfficerSVP & Cfo Apr 12, 2022
Scott Graeser Individual Corporate OfficerVP & Treasurer Aug 19, 2022
William Little Individual Contracted Managing EmployeeCeo Carolina Pines Reg Med Center Nov 16, 2018
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 98.7%
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Jan 21, 2022
Knight Intermediate Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 98.7%
Richard L Algood Individual Corporate OfficerSr. Vice President, Reimbursement Jan 21, 2022
Knight Healthcare New-B, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 98.7%
Knight Health II, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 98.7%
Kathy Jane Teague Individual Corporate OfficerVice President, Corporate Secretary Jan 21, 2022

Facilities with the same owner 97

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

  • Andalusia Physician Practices LLC

    dba Andalusia Family Healthcare

    • Rural Health Clinic/Center
    • Andalusia, AL
    • NPI 1417663576

    Knight Health Holdings LLC, Knight Health II, LLC, Knight Intermediate Holdings LLC

    CMS ownership
  • CHG Hospital Austin, LLC

    dba Cornerstone Specialty Hospitals Round Rock

    • Rehabilitation Hospital Unit
    • Round Rock, TX
    • NPI 1396326948

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Austin, LLC

    dba Cornerstone Specialty Hospitals Round Rock

    • Long Term Care Hospital
    • Round Rock, TX
    • NPI 1912395203

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Conroe, LLC

    dba Cornerstone Specialty Hospitals Conroe

    • Long Term Care Hospital
    • Conroe, TX
    • NPI 1073901476

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • CHG Hospital Little Rock, LLC

    dba Cornerstone Specialty Hospitals Little Rock

    • Long Term Care Hospital
    • Little Rock, AR
    • NPI 1346630589

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Intermediate Holdings LLC

    CMS ownership
  • CHG Hospital McAllen, LLC

    dba Solara Specialty Hospitals McAllen

    • Long Term Care Hospital
    • McAllen, TX
    • NPI 1760870166

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Community Hospital of Andalusia LLC

    dba Andalusia Health

    • General Acute Care Hospital
    • Andalusia, AL
    • NPI 1821078494

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health II, LLC

    CMS ownership
  • Cornerstone Hospital of Huntington, LLC

    dba Cornerstone Specialty Hospitals Huntington

    • Long Term Care Hospital
    • Huntington, WV
    • NPI 1548214786

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Dallas Ltach, LLC

    dba Kindred Hospital Dallas Central

    • Long Term Care Hospital
    • Dallas, TX
    • NPI 1356559991

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Intermediate Holdings LLC

    CMS ownership
  • Dallas Ltach, LLC

    dba Kindred Hospital Dallas Central (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Dallas, TX
    • NPI 1821741539

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Intermediate Holdings LLC

    CMS ownership
  • Kindred Chicago Northlake, LLC

    dba Kindred Hospital - Chicago (Northlake Campus)

    • Long Term Care Hospital
    • Northlake, IL
    • NPI 1508472804

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
  • Kindred Development 17, LLC

    dba Kindred Hospital Melbourne

    • Long Term Care Hospital
    • Melbourne, FL
    • NPI 1497983936

    Kindred Healthcare Operating LLC, Knight Health Holdings LLC

    CMS ownership
View all 97

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

Affiliated clinicians 169

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 169

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1174500458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "fax_number": "502-212-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-2100",
            "fax_number": "843-339-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274290",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2679",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340464",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carolinapinesregmedcen@capella.medalliesdirect.net",
            "affiliation": "N",
            "address_1": "1304 W Bobo Newsom Hwy",
            "city": "Hartsville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295504710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Carolina Pines Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Pines Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartsville, SC

Sources for this page

Verify at the official NPI Registry.