NPIMap

Organization Active NPI

Presbyterian Communities of South Carolina

Doing business as Presbyterian Communities of SC - Summerville

  • Skilled Nursing Facility
  • Summerville, SC
National Provider Identifier
1396940649
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF 202 Issued in SC
Legal business name
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA
Doing business as
Presbyterian Communities of SC - Summerville
Practice address
201 W 9TH North St
Summerville, SC 29483-6721
Phone
(843) 873-2550
NPI assigned
Jun 18, 2007
Organization subpart
Yes
Parent organization
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Mr. Kevin Johnson, CPA
Title
Chief Financial Officer
Phone
(803) 772-5885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCF 202 SC Primary

Addresses

Primary practice location

201 W 9TH North St
Summerville, SC 29483-6721

Mailing address

201 W 9TH North St
Summerville, SC 29483-6721
Phone (843) 873-2550

Other names 1

  • Presbyterian Communities of SC - Summerville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000299 SC Part A Provider - Skilled Nursing Facility 3375627664 Practice locations: Summerville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396940649. Details of each certification follow.

Skilled nursing facility certification: CCN 425389

Legal name
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA
Doing business as
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA- SUMMERVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 15, 2009
Last certification
Sep 6, 2024
Beds
87 (48 certified)
Ownership / control type
Nonprofit Corporation
Multi-facility organization
PRESBYTERIAN COMMUNITEIS OF SC
Organization structure
CorporationNon-profit
Incorporated
May 18, 1954 in SC
Enrollment address
201 W 9TH North Street
Summerville, SC 29483-6721
Nursing home name
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA-SUMMERV
Affiliated entity
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA

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: Nursing home

Medicare Care Compare
Listed as
Presbyterian Communities Of South Carolina-SummervCCN 425389 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 15, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4839.1 residents per day on average
Chain
Presbyterian Communities of South Carolina5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Communities of South Carolina5 organizations share this tax ID, including this one
Part of
Presbyterian Communities of South Carolina

Other organizations with this tax ID 4

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

Locations

2817 Ashland Rd
Columbia, SC 29210

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2025
Luther Franklin Fant Individual Corporate OfficerChief Executive Officer Jun 1, 2020 100%
Operational/Managerial Control Jun 1, 2020
Adp of the SNF Jun 1, 2020
Presbyterian Communities of South Carolina Organization, Columbia, SC Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jun 20, 2007 100%
Kevin Johnson Individual Corporate OfficerChief Financial Officer Jul 3, 2023
Adp of the SNF Jul 3, 2025
Amanda Stamper Individual Corporate OfficerChief Operating Officer Mar 5, 2021
Operational/Managerial Control Mar 5, 2021
Adp of the SNF Mar 5, 2021
Casey Caddell Individual Operational/Managerial Control Jun 10, 2025
Adp of the SNF Jun 10, 2025

Owners & managing parties with NPI records 4

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
Presbyterian Home of South Carolina - ClintonClinton, SC, CCN 425393 Skilled nursing facility 5% Or Greater Direct Ownership Interest Mar 17, 2008
Presbyterian Home of South Carolina - FoothillsEasley, SC, CCN 425403 Skilled nursing facility 5% Or Greater Direct Ownership Interest Mar 17, 2008
Presbyterian Home of South Carolina-ColumbiaLexington, SC, CCN 425396 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 18, 1954
Presbyterian Communities of South Carolina - FlorenceFlorence, SC, CCN 425406 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1981

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1396940649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 9TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836721",
            "telephone_number": "843-873-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 9TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836721",
            "telephone_number": "843-873-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA",
        "enumeration_date": "2007-06-18",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-772-5885",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF 202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Communities of SC - Summerville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Communities of SC - Summerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.