NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting Office

Doing business as C M Tucker Jr Nursing Care Center

  • Skilled Nursing Facility
  • Columbia, SC
National Provider Identifier
1225080260
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
C M Tucker Jr Nursing Care Center
Practice address
2200 Harden St
Columbia, SC 29203-7107
Phone
(803) 898-8405
NPI assigned
May 17, 2006
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CAROLINA DEPT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Versie Bellamy
Title
Deputy Director
Phone
(803) 935-5761

Specialties & licenses 1

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

Addresses

Primary practice location

2200 Harden St
Columbia, SC 29203-7107

Mailing address

PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
450746MedicaidSC

Other names 1

  • C M Tucker Jr Nursing Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000630 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 136 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC; Charleston, SC; Anderson, SC; Aiken, SC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pee Dee Mental Health C61 organizations share this tax ID, including this one
Part of
Pee Dee Mental Health C

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1225080260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 485",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020485",
            "telephone_number": "803-898-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HARDEN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037107",
            "telephone_number": "803-898-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "BELLAMY",
        "authorized_official_first_name": "VERSIE",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "803-935-5761"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "450746",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C M Tucker Jr Nursing Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "C M Tucker Jr Nursing Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.