NPIMap

Organization Active NPI

Easley Skilled Nursing, LLC

Doing business as Fleetwood Post Acute

  • Skilled Nursing Facility
  • Easley, SC
National Provider Identifier
1467125708
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EASLEY SKILLED NURSING, LLC
Doing business as
Fleetwood Post Acute
Practice address
200 Anne Dr
Easley, SC 29640-2061
Phone
(864) 859-9754
NPI assigned
Jul 30, 2021
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

200 Anne Dr
Easley, SC 29640-2061

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Fleetwood Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220105003049 SC Part A Provider - Skilled Nursing Facility 8729479522 Practice locations: Easley, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467125708. Details of each certification follow.

Skilled nursing facility certification: CCN 425018

Legal name
EASLEY SKILLED NURSING, LLC
Doing business as
FLEETWOOD POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1971
Last certification
May 6, 2025
Beds
103
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Nov 27, 2013
Organization structure
LLCProprietary
Incorporated
Jun 29, 2021 in SC
Enrollment address
200 Anne Dr
Easley, SC 29640-2061
Nursing home name
FLEETWOOD POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fleetwood Post AcuteCCN 425018 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10393.9 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
2Fines totaling $14,842

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 29, 2021 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Jun 29, 2021 50%
Corporate OfficerPresident/Ceo Jun 29, 2021
John T Mitchell Individual Corporate OfficerVice President/Asst Secretary Jun 29, 2021
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Palmetto Community Healthcare, LLC Organization, Farmington, UT Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 29, 2021 100%
Joshua O Jergensen Individual Corporate OfficerPresident, Manager Aug 1, 2025
Operational/Managerial Control Aug 1, 2025
Jordan Hall Individual Operational/Managerial ControlAdministrator Sep 1, 2021
Adp of the SNF Sep 21, 2021
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Jun 29, 2021 50%
Corporate OfficerVice President/Cfo/Secretary Jun 29, 2021

Facilities with the same owner 80

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

View all 80

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1467125708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ANNE DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402061",
            "telephone_number": "864-859-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASLEY SKILLED NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleetwood Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fleetwood Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.