NPIMap

Organization Active NPI

Thi of South Carolina at Rock Hill, LLC

  • Skilled Nursing Facility
  • Rock Hill, SC
National Provider Identifier
1306933593
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THI OF SOUTH CAROLINA AT ROCK HILL, LLC
Practice address
127 Murrah Dr
Rock Hill, SC 29732-2342
Phone
(803) 324-7591
Fax
(803) 327-4638
NPI assigned
Oct 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Elbert Mask
Title
President
Phone
(803) 324-7591

Facilities with the same owner 40

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

View all 40

Affiliated clinicians 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Magnolia Manor - Rock HillCCN 425165
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 27, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10695.0 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Penalties (3 years)
5Fines totaling $128,214

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
42D0926531Magnolia Manor - Rock Hill127 Murrah Drive, Rock Hill, SC 29732Certificate of waiverMar 24, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623000780 SC Part A Provider - Skilled Nursing Facility 8022093939 Practice locations: Rock Hill, SC

Skilled nursing facility certification: CCN 425165

Legal name
THI OF SOUTH CAROLINA AT ROCK HILL, LLC
Doing business as
MAGNOLIA MANOR-ROCK HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 27, 1988
Last certification
Aug 1, 2024
Beds
106
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Fundamental Administrative Services
Organization structure
LLCProprietary
Incorporated
May 19, 2003 in DE
Enrollment address
127 Murrah Dr
Rock Hill, SC 29732-2342
Nursing home name
MAGNOLIA MANOR - ROCK HILL
Affiliated entity
FUNDAMENTAL HEALTHCARE

All disclosed owners & managing parties 6

Medicare enrollment files

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

NameRoleSinceShare
Laurie Wilson Individual Corporate OfficerVP Treasurer Secretary Oct 6, 2008
Anthony Brice Individual Corporate OfficerPresident/ Administrator Aug 12, 2019
W-2 Managing EmployeeAdministrator Aug 12, 2019
Thi of South Carolina, LLC Organization, Greenwood, SC For-profit 5% Or Greater Direct Ownership Interest Aug 30, 2003 100%
Murray Forman Individual 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%
Thi of Baltimore, Inc. Organization, Sparks, MD For-profit 5% Or Greater Indirect Ownership Interest Aug 30, 2003 100%
Hunt Valley Holdings LLC Organization, Sparks, MD For-profit 5% Or Greater Indirect Ownership Interest Mar 28, 2006 100%

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

NPPES NPI Registry

Primary practice location

127 Murrah Dr
Rock Hill, SC 29732-2342

Mailing address

930 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0859NFMedicaidSC

Other names 1

NPPES NPI Registry
  • Magnolia Manor - Rock Hill Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2008.

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1306933593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MURRAH DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322342",
            "telephone_number": "803-324-7591",
            "fax_number": "803-327-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF SOUTH CAROLINA AT ROCK HILL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "MASK",
        "authorized_official_first_name": "ELBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-324-7591"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0859NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Manor - Rock Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.