NPIMap

Organization Active NPI

Lutheran Homes of SC, Inc.

Doing business as Lutheran Hospice

  • Community Based Hospice Care Agency
  • Chapin, SC
National Provider Identifier
1275531758
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HPC-041 Issued in SC
Legal business name
LUTHERAN HOMES OF SC, INC.
Doing business as
Lutheran Hospice
Practice address
102 Fortress Dr
Chapin, SC 29036
Phone
(803) 461-0456
Fax
(803) 461-0727
NPI assigned
Jul 8, 2005
Last updated
Jul 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Authorized official

Name
Mr. Parke B Horton
Title
Cfo
Phone
(803) 749-5116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HPC-041 SC Primary

Addresses

Primary practice location

102 Fortress Dr
Chapin, SC 29036

Mailing address

300 Ministry Dr
Irmo, SC 29063-2366
Phone (803) 749-5110

Other identifiers 1

IdentifierTypeStateIssuer
HSP477005MedicaidSC

Other names 1

  • Lutheran Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060403000296 SC Part A Provider - Hospice 0143238113 Practice locations: Chapin, SC; Greenville, SC; Mt. Pleasant, SC; Newberry, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275531758. Details of each certification follow.

Hospice certification: CCN 421529

Legal name
LUTHERAN HOMES OF SC, INC.
Doing business as
LUTHERAN HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 19, 1995
Last certification
Feb 11, 2021
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Apr 18, 1924 in SC
Enrollment address
102 Fortress Drive
Chapin, SC 29036

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Lutheran HospiceCCN 421529 · All quality measures
Ownership
Other
Certified
May 19, 1995
Medicare certification status
ActiveFrom the Provider of Services file

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
42D2179588Lutheran Hospice102 Fortress Drive, Chapin, SC 29036Certificate of waiverFeb 25, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
John Gould Individual Contracted Managing EmployeeMD; Oct 1, 2024
Gregory a Estes Individual W-2 Managing EmployeeAdmistrator Nov 23, 2016
Frank T Shepke Individual Corporate Officer Mar 1, 2015
Charles D Coleman Individual Corporate Officer Jul 1, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rosecrest Rehabilitation and Healthcare CenterInman, SC, CCN 425376 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 23, 1994
Sep 23, 1994
The Heritage at Lowman Rehabilitation and HealthcareWhite Rock, SC, CCN 425100 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Sep 23, 1994
Sep 23, 1994
Sep 23, 1994
Franke Health Care CenterMt Pleasant, SC, CCN 425374 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 23, 1994
Sep 23, 1994
Rice Estate Rehabilitation and HealthcareColumbia, SC, CCN 425387 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2023
Sep 23, 1994

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 12

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": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1275531758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MINISTRY DR",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632366",
            "telephone_number": "803-749-5110",
            "fax_number": "803-749-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FORTRESS DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "29036",
            "telephone_number": "803-461-0456",
            "fax_number": "803-461-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOMES OF SC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "PARKE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "803-749-5116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC-041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP477005",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lutheran Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chapin, SC

Sources for this page

Verify at the official NPI Registry.