Active NPI
Palmetto Springdale Operating LLC
- Skilled Nursing Facility
- Camden, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NCF-842
- Legal business name
- PALMETTO SPRINGDALE OPERATING LLC
- Practice address
- 146 Battleship Rd
Camden, SC 29020-2060 - Phone
- (803) 432-3741
- Fax
- (803) 432-6056
- NPI assigned
- Oct 24, 2006
- 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
- Debbie Sparks
- Title
- Administrator
- Phone
- (803) 432-6056
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NCF-842 | SC | Primary |
Addresses
Primary practice location
146 Battleship Rd
Camden, SC 29020-2060
Mailing address
146 Battleship Rd
Camden, SC 29020-2060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0925NF | Medicaid | SC |
Other names 1
- Springdale Healthcare 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 |
|---|---|---|---|---|
| O20061129000109 | SC | Part A Provider - Skilled Nursing Facility | 7810995834 | Practice locations: Camden, SC |
Skilled nursing facility certification: CCN 425169
- Legal name
- PALMETTO SPRINGDALE OPERATING LLC
- Doing business as
- SPRINGDALE HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 6, 1989
- Last certification
- Mar 1, 2025
- Beds
- 148
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- FUNDAMENTAL- PALMETTO
- Organization structure
- LLC
- Incorporated
- Aug 30, 2006 in DE
- Enrollment address
- 146 Battleship Rd
Camden, SC 29020-2060 - Nursing home name
- SPRINGDALE HEALTHCARE CENTER
- Affiliated entity
- FUNDAMENTAL HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Springdale Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 6, 1989
- Medicare certification status
- Active
- Certified beds
- 148
- Chain
- Fundamental Healthcare
- 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 |
|---|---|---|---|
| 42D0895517 | Springdale Healthcare Center | Certificate of waiver | Dec 11, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Binyue Chang | Operational/Managerial Control | Jul 1, 2024 | |
| Adp of the SNF | Jul 1, 2024 | ||
| Palmetto Health Care LLC | 5% Or Greater Direct Ownership Interest | Jun 18, 2009 | 100% |
| Operational/Managerial Control | Jun 18, 2009 | ||
| Fundamental Clinical and Operational Services, LLC | Adp of the SNF | Sep 23, 2006 | |
| Katelyn Hanley | Adp of the SNF | Mar 21, 2023 | |
| Murray Forman | 5% Or Greater Indirect Ownership Interest | Aug 22, 2006 | 99% |
| Kenneth a Tabler | Corporate Officer | Aug 15, 2015 | |
| Operational/Managerial Control | Aug 15, 2015 | ||
| Fundamental Administrative Services LLC | Adp of the SNF | Sep 23, 2006 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Lexington, SC
- NPI 1427497817
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Florence, SC
- NPI 1053493684
Palmetto Health Care LLC
-
- Skilled Nursing Facility
- Orangeburg, SC
- NPI 1093897639
Palmetto Health Care LLC
-
- Skilled Nursing Facility
- Scranton, SC
- NPI 1245314699
Palmetto Health Care LLC
-
- Skilled Nursing Facility
- Georgetown, SC
- NPI 1548344906
Palmetto Health Care LLC
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": "1161648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1392076800000",
"number": "1457435844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 BATTLESHIP RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290202060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "146 BATTLESHIP RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290202060",
"telephone_number": "803-432-3741",
"fax_number": "803-432-6056"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO SPRINGDALE OPERATING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-24",
"last_updated": "2014-02-11",
"status": "A",
"authorized_official_last_name": "SPARKS",
"authorized_official_first_name": "DEBBIE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "803-432-6056"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "SC",
"license": "NCF-842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0925NF",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Springdale Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Camden, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.