Active NPI
Spring Street Senior Housing Opco, LLC
- Assisted Living Facility
- Charleston, SC
National Provider Identifier
1396499224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- SPRING STREET SENIOR HOUSING OPCO, LLC
- Doing business as
- Spring Street Health Center
- Practice address
- 194 Spring Street
Charleston, SC 29403 - Phone
- (843) 754-6940
- Fax
- (943) 865-8123
- NPI assigned
- Feb 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph V Calcutt
- Title
- Cfo
- Phone
- (910) 815-3122
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary | ||
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
194 Spring Street
Charleston, SC 29403
Mailing address
44 McNeill PLZ
Whiteville, NC 28472-8602
Phone (910) 642-0224
Other names 1
- Spring Street Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220817002910 | SC | Part A Provider - Skilled Nursing Facility | 9638552011 | Practice locations: Charleston, SC |
Skilled nursing facility certification: CCN 425418
- Legal name
- SPRING STREET SENIOR HOUSING OPCO, LLC
- Doing business as
- KEMPTON OF CHARLESTON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Oct 6, 2022
- Last certification
- May 6, 2025
- Beds
- 23
- Ownership / control type
- Corporation
- Multi-facility organization
- LIBERTY SENIOR LIVING
- Organization structure
- LLC
- Enrollment address
- 194 Spring St
Charleston, SC 29403-5556 - Nursing home name
- KEMPTON OF CHARLESTON
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Kempton Of Charleston
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- Oct 6, 2022
- Medicare certification status
- Active
- Certified beds
- 23
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2249226 | Kempton of Charleston | Certificate of waiver | Jan 18, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Karep V Senior Housing Reoc JV LLC | Other | Mar 11, 2022 | 100% |
| Karep V SL Reit, LLC | Other | Mar 11, 2022 | 89.1% |
| Spring Street Senior Housing JV Opco, LLC | 5% Or Greater Direct Ownership Interest | May 4, 2020 | 100% |
| Operational/Managerial Control | May 4, 2020 | 100% | |
| Albert Rabil | Corporate Officer | May 4, 2020 | |
| John Wain | Corporate Officer | May 4, 2020 | |
| Liberty Development of Charleston, LLC | Other | Mar 11, 2022 | 5% |
| Kayne Anderson Real Estate Partners V LP (Karep V) | Other | May 4, 2020 | 100% |
| Liberty Southern CSL, LLC | Other | May 4, 2020 | 5% |
| Senior Housing Intervening Company V LLC | Other | May 4, 2020 | 90% |
| Russell Reiter | Corporate Officer | May 4, 2020 | |
| David Sydney Selznick | Corporate Officer | May 4, 2020 | |
| Lindsay French | Operational/Managerial Control | Mar 1, 2022 | 100% |
| Penny T. Purifoy | Corporate Director | Mar 11, 2022 | |
| W-2 Managing Employee | Mar 11, 2022 | ||
| Matthew L Bork | Corporate Officer | May 4, 2020 | 100% |
| Kayne Anderson Real Estate Partners V Parallel Fund LP | Other | May 4, 2020 | 100% |
| William B Purvis | Corporate Officer | May 4, 2020 | |
| Operational/Managerial Control | May 4, 2020 | ||
| Karep V Parallel SL Reit LLC | Other | May 4, 2020 | 10.9% |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Charleston, SC
- NPI 1407118508
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644364800000",
"number": "1396499224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MCNEILL PLZ",
"city": "WHITEVILLE",
"state": "NC",
"postal_code": "284728602",
"telephone_number": "910-642-0224",
"fax_number": "910-642-8537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "194 SPRING STREET",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29403",
"telephone_number": "843-754-6940",
"fax_number": "943-865-8123"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPRING STREET SENIOR HOUSING OPCO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-09",
"last_updated": "2022-02-09",
"certification_date": "2021-11-23",
"status": "A",
"authorized_official_last_name": "CALCUTT",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "910-815-3122"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Spring Street Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.