NPIMap

Organization Active NPI

Piedmont Skilled Nursing, LLC

  • Skilled Nursing Facility
  • Piedmont, SC
National Provider Identifier
1184397432
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PIEDMONT SKILLED NURSING, LLC
Doing business as
Piedmont Post Acute
Practice address
109 Bentz Rd
Piedmont, SC 29673-1412
Phone
(864) 845-5177
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

109 Bentz Rd
Piedmont, SC 29673-1412

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Piedmont Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220106001449 SC Part A Provider - Skilled Nursing Facility 6901297639 Practice locations: Piedmont, SC

Skilled nursing facility certification: CCN 425314

Legal name
PIEDMONT SKILLED NURSING, LLC
Doing business as
PIEDMONT POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 3, 1991
Last certification
Apr 9, 2025
Beds
88
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS
Organization structure
LLCProprietary
Incorporated
Jun 29, 2021 in SC
Enrollment address
109 Bentz Rd
Piedmont, SC 29673-1412
Nursing home name
PIEDMONT POST-ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Piedmont Post-AcuteCCN 425314 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 3, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8881.8 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $8,018

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
42D0716396Piedmont Skilled Nursing, LLC109 Bentz Road, Piedmont, SC 29673Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 29, 2021 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Reinaldo Hall Individual W-2 Managing EmployeeAd; Oct 4, 2022
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Palmetto Community Healthcare, LLC Organization, Farmington, UT Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Jun 29, 2021 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Henry Igdal Individual Contracted Managing EmployeeMD; Sep 21, 2021
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

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 80

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

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1184397432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BENTZ RD",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296731412",
            "telephone_number": "864-845-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT SKILLED NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piedmont Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Piedmont, SC

Sources for this page

Verify at the official NPI Registry.