Organization Active NPI

Palmetto Springdale Operating LLC

  • Skilled Nursing Facility
  • Camden, SC
National Provider Identifier
1457435844
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF-842 Issued in SC
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

Updated by the provider on Feb 11, 2014

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0925NFMedicaidSC

Other names 1

  • Springdale Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 425169
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 6, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
148136.8 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Penalties (3 years)
1Fines totaling $16,985

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0895517Springdale Healthcare Center146 Battleship Road, Camden, SC 29020Certificate of waiverDec 11, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Binyue Chang Individual Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
Palmetto Health Care LLC Organization, Sparks, MD LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 18, 2009 100%
Operational/Managerial Control Jun 18, 2009
Fundamental Clinical and Operational Services, LLC Organization, Sparks, MD LLC Adp of the SNF Sep 23, 2006
Katelyn Hanley Individual Adp of the SNF Mar 21, 2023
Murray Forman Individual 5% Or Greater Indirect Ownership Interest Aug 22, 2006 99%
Kenneth a Tabler Individual Corporate OfficerPresident Aug 15, 2015
Operational/Managerial Control Aug 15, 2015
Fundamental Administrative Services LLC Organization, Sparks, MD 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.

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": "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

Verify at the official NPI Registry.