Brightwater Retirement, LLC
Organization Active NPI Skilled Nursing Facility · Myrtle Beach, SC
NPI 1407090434 · NPPES record last updated Jan 14, 2016
Key facts
- NPI
- 1407090434
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NCF-0955 (SC)
- Legal business name
- BRIGHTWATER RETIREMENT, LLC
- Practice address
- 101 Brightwater Dr
Myrtle Beach, SC 29579-8268 - Phone
- (843) 903-8300
- Fax
- (843) 236-1644
- NPI assigned
- Apr 21, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Gary Ventola
- Title
- Sr. VP of Administration
- Phone
- (704) 246-1610
Owners & managing parties with NPI records 1
Corporate family (same tax ID) 1
Facilities with the same owner 10
Affiliated clinicians 3
-
Faisal Majeed, M.D
Medicare Care Compare: Nursing home
- Listed as
- Brightwater Skilled Nursing Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 23, 2009
- Medicare certification status
- Active
- Certified beds
- 67 · 50.8 residents per day on average
- Chain
- Senior Living Communities
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Skilled nursing facility certification: CCN 425395
- Legal name
- BRIGHTWATER RETIREMENT, LLC
- Doing business as
- THE RETREAT AT BRIGHTWATER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 23, 2009
- Last certification
- Apr 30, 2025
- Beds
- 67
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Maxwell Group
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 13, 2007 in SC
- Enrollment address
- 101 Brightwater Dr
Myrtle Beach, SC 29579-8275 - Nursing home name
- BRIGHTWATER SKILLED NURSING CENTER
- Affiliated entity
- SENIOR LIVING COMMUNITIES
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Timothy Bruce Bradford |
Adp of the SNF | Mar 7, 2025 | |
| Benjamin M. Thompson |
5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 25% |
| Corporate Officer |
Jul 1, 2022 | ||
| Operational/Managerial Control | Jul 1, 2022 | ||
| Joshua E. Thompson |
5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 25% |
| Donald Thompson |
5% Or Greater Indirect Ownership Interest | Jul 20, 2009 | 50% |
| Corporate Director |
Jul 20, 2009 | ||
| Managing Control - Governing Body |
Jul 20, 2009 | ||
| Senior Living Commuities LLC |
5% Or Greater Direct Ownership Interest | Jul 20, 2009 | 100% |
| |
Adp of the SNF | Dec 1, 2014 | |
| Matthew Arledge |
Adp of the SNF | Mar 5, 2025 | |
| Maxwell Group, Inc. |
Operational/Managerial Control | Nov 14, 2007 | |
| Adp of the SNF | Jan 30, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090827000313 | SC | Part a Provider - Skilled Nursing Facility | 0941355986 | Practice locations: Myrtle Beach, SC |
National Provider Directory
- Tax ID family
- Brightwater
Locations
171 Brightwater Dr
Myrtle Beach, SC 29579
Phone (843) 903-0786
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Assisted Living Facility | 310400000X | CRC-1489 | SC | |
| Skilled Nursing Facility | 314000000X | NCF-0955 | SC | Yes |
Addresses
Primary practice location
101 Brightwater Dr
Myrtle Beach, SC 29579-8268
Mailing address
101 Brightwater Dr
Myrtle Beach, SC 29579-8268
Phone (843) 903-8300
Other names
- Brightwater
Other providers in Myrtle Beach, SC
- Brian J Roberts MD
- Dina Bright
- Brighter Horizons Counseling, LLC
- Robert Rashad Brightharp
- Brightwater Retirement, LLC
- Matthew Leon Brigmon
- Angela Maria Brinegar
- Lindsay Jane Brock
- Stephen Arnold Bromell Jr.
- Hiram B Brooks
All providers in Myrtle Beach, SC · Skilled Nursing Facility in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.