NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting Office

  • Skilled Nursing Facility
  • Columbia, SC
National Provider Identifier
1316972722
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF726 Issued in SC
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Practice address
2200 Harden St
Columbia, SC 29203-7107
Phone
(803) 898-8405
NPI assigned
Jul 12, 2006
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 NCF726 SC Primary

Addresses

Primary practice location

2200 Harden St
Columbia, SC 29203-7107

Mailing address

2414 Bull St
Columbia, SC 29201-1906
Phone (803) 898-8405

Other identifiers 1

IdentifierTypeStateIssuer
0726NFMedicaidSC

Other names 1

  • C. M. Tucker, Jr. Nursing Care Center - Roddey Pavillion Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031215000552 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 42 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charleston, SC; North Charleston, SC; Columbia, SC
O20061211000074 SC Part A Provider - Skilled Nursing Facility 9032021175 Practice locations: Columbia, SC

Skilled nursing facility certification: CCN 425360

Legal name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
C.M. TUCKER JR NURSING CARE CENTER-RODDEY PAVILLION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 3, 1997
Last certification
Apr 18, 2025
Beds
308
Ownership / control type
State
Organization structure
OtherNon-profit
Incorporated
in SC
Enrollment address
2200 Harden St
Columbia, SC 29203-7107
Nursing home name
C M TUCKER JR NURSING CARE CENTER RODDEY PAVILION

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
C M Tucker Jr Nursing Care Center Roddey PavilioCCN 425360
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Oct 3, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
30883.7 residents per day on average
Penalties (3 years)
3Fines totaling $59,779

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Lexington Co Comm Men H

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
Robert Morgan Individual W-2 Managing Employee Sep 1, 2016
Versie J Bellamy Individual W-2 Managing Employee Sep 1, 2016
Tracy Turner Individual W-2 Managing EmployeeAdministrator May 10, 2012
South Carolina Dept of Mental Health Accounting Office Organization, Columbia, SC 5% Or Greater Direct Ownership Interest Jan 1, 2006

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
South Carolina Dept of Mental Health Accounting OfficeColumbia, SC, CCN 424005 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1978
Patrick B Harris Psychiatric HospitalAnderson, SC, CCN 424011 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 7, 2016
Dec 29, 1986
CM Tucker Jr Nursing CareColumbia, SC, CCN 425074 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1970
Jan 1, 1970

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 226

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 226

Affiliated clinicians 2

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1316972722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 BULL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011906",
            "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": "2006-07-12",
        "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": "SC",
            "license": "NCF726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0726NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C. M. Tucker, Jr. Nursing Care Center - Roddey Pavillion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "C. M. Tucker, Jr. Nursing Care Center - Roddey Pavillion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.