NPIMap

Organization Active NPI

Walterboro Community Hospital, Inc.

  • General Acute Care Hospital
  • Walterboro, SC
National Provider Identifier
1376597997
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
WALTERBORO COMMUNITY HOSPITAL, INC.
Practice address
501 Robertson Blvd
Walterboro, SC 29488-2787
Phone
(843) 782-2000
Fax
(843) 549-0246
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Authorized official

Name
Cassie L. Ball
Title
Cfo
Phone
(843) 782-2602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

501 Robertson Blvd
Walterboro, SC 29488-2787

Mailing address

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 782-2000

Other identifiers 19

IdentifierTypeStateIssuer
05776536MedicaidMS
0761715MedicaidOH
1600352MedicaidKY
1729051MedicaidLA
284106OtherFLAVMED
94441600MedicaidFL
281455200MedicaidMD
200228330AMedicaidIN
029456MedicaidAZ
154901000OtherDEPT OF LABOR
324008MedicaidSC
4200030MedicaidNC
0048607MedicaidNJ
072793501MedicaidTX
420030OtherHIGHMARK BC
431914100MedicaidME
00504061XMedicaidGA
1707597MedicaidNY
COL0030NMedicaidAL

Other names 1

  • HCA Healthcare Colleton Hospital Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network
Direct Messaging Address COLLETON.COCDAB.SCA@CCDA.HCADIRECT.NET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070709000462 SC Part A Provider - Hospital 5395638183 Practice locations: Walterboro, SC

Hospital certification: CCN 420030

Legal name
WALTERBORO COMMUNITY HOSPITAL INC
Doing business as
HCA HEALTHCARE COLLETON HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 10, 2021
Beds
135
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Enrollment address
501 Robertson Blvd
Walterboro, SC 29488-2787
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Colleton Medical CenterCCN 420030
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Colleton Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: colleton.cocdab.sca@ccda.hcadirect.net

Ownership & related parties

All disclosed owners & managing parties 37

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

NameRoleSinceShare
Michael McAlevey Individual Corporate Officer Feb 1, 2022
Jaime L Derensis Individual Corporate Officer Nov 4, 2020
HCA Inc Organization, Nashville, TN For-profit 5% Or Greater Indirect Ownership Interest May 31, 2007 100%
John M Franck Individual Corporate Director May 31, 2007
Douglas L Downey Individual Corporate Officer Apr 7, 2014
Eric D Smith Individual Contracted Managing EmployeeVice President of Reimbursement Mar 1, 2021
Other Mar 1, 2021
HCA Healthcare Inc Organization, Nashville, TN For-profit 5% Or Greater Indirect Ownership Interest Sep 26, 2011 100%
Henry Todd Maxwell Individual Corporate Officer Jan 1, 2024
Frisco Holding II Organization, Nashville, TN Holding company 5% Or Greater Indirect Ownership Interest Feb 6, 2026 16.3%
Christopher F Wyatt Individual Corporate Director Apr 18, 2016
John I Starling Individual Corporate OfficerAssistant Secretary Oct 7, 2019
Shirley E Scharf-Cheatham Individual Corporate Officer Sep 27, 2020
Richard Hammett Individual Corporate Officer Jan 1, 2023
John M Hackett Individual Corporate Officer Apr 18, 2016
Hercules Holding II Organization, Nashville, TN Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 17, 2006 14.4%
Samuel N Hazen Individual Corporate Director Aug 24, 2011
Ronald Lee Grubbs Individual Corporate Officer Jan 1, 2010
Monica Cintado Individual Corporate OfficerVice President of Development Oct 7, 2019
Jon Foster Individual Corporate Officer Jan 1, 2023
Healthtrust Inc - the Hospital Company Organization, Nashville, TN For-profit 5% Or Greater Indirect Ownership Interest May 31, 2007 100%
Seth a Killingbeck Individual Corporate Officer Aug 29, 2012
Ricardo Pavon Individual Corporate Officer Nov 4, 2020
Timothy Scott Noonan Individual Corporate Officer Apr 5, 2013
Natalie H Cline Individual Corporate Officer Apr 5, 2013
Cassie Ball Individual Corporate OfficerCfo Apr 9, 2018
W-2 Managing EmployeeCfo Apr 9, 2018
Michael T Bray Individual Corporate Officer Jan 1, 2010
Matthew R Favicchio Individual Corporate Officer Sep 5, 2025
Peter J Rossell Individual Corporate Officer Jan 1, 2023
Ashley T Lacaze Individual Corporate OfficerDivision Cfo Apr 15, 2019
Michael a Marks Individual Corporate Officer May 1, 2024
Edwin W Robinson Individual Corporate Officer Sep 5, 2025
Brad Ej Spicer Individual Corporate Officer Jan 1, 2023
Hugh Carter Tappan Individual Corporate Officer Jan 1, 2015
Hti Hospital Holdings Inc Organization, Nashville, TN For-profit 5% Or Greater Direct Ownership Interest May 31, 2007 100%
Kevin a Ball Individual Corporate Officer Apr 7, 2014
Jeffery McInturff Individual Corporate Officer Nov 29, 2021
Deborah H Mullin Individual Corporate Officer Jan 1, 2010

Facilities with the same owner 132

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

View all 132

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

Affiliated clinicians 248

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

View all 248

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1376597997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-782-2000",
            "fax_number": "843-549-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-782-2000",
            "fax_number": "843-549-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTERBORO COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-782-2602"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05776536",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0761715",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1600352",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1729051",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "284106",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94441600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281455200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200228330A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029456",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "154901000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324008",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4200030",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048607",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072793501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC",
            "identifier": "420030",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431914100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00504061X",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1707597",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "COL0030N",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "COLLETON.COCDAB.SCA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "Please contact CORP.HCACEP@HCAHealthcare.com for information regarding validation steps that may be required to ensure CCDs sent to the listed direct address are successfully received.",
            "address_1": "501 Robertson Blvd",
            "city": "Walterboro",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294882787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HCA Healthcare Colleton Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

Verify at the official NPI Registry.