Sedgewood Manor Healthcare Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SEDGEWOOD MANOR HEALTHCARE CENTER LLC

Practice address

1645 Ridge Rd
Hopkins, SC 29061-8432

Phone

(803) 776-3873

Fax

(803) 217-0365

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Savitri Johnson

Title

Administrative Assistant

Phone

(863) 226-0358

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sedgewood Manor Healthcare Center Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Skilled nursing facility certification: CCN 425370

Legal name

SEDGEWOOD MANOR HEALTH CARE CENTER LLC

Doing business as

SEDGEWOOD MANOR HEALTH CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 17, 2000

Last certification

Jul 10, 2024

Beds

38

Ownership / control type

Corporation

Multi-facility organization

Mainstay

Organization structure

LLCProprietary

Enrollment address

1645 Ridge Rd
Hopkins, SC 29061-8432

Nursing home name

SEDGEWOOD MANOR HEALTH CARE CENTER

Listed as

Sedgewood Manor Health Care CenterCCN 425370

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

May 17, 2000

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3829.0 residents per day on average

Penalties (3 years)

1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Countrywood Nursing Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Sedgewood Manor Healthcare Center LLC

  • Assisted Living Facility
  • Hopkins, SC
  • NPI 1619572054
  NPD tax ID

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Peter K Maung, MD, FACP, CMD

  • Geriatric Medicine (Internal Medicine) Physician
  • Charleston, SC
  • NPI 1740219922

  Adp of the SNF

  CMS ownership

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1467517649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 RIDGE RD",
            "city": "HOPKINS",
            "state": "SC",
            "postal_code": "290618432",
            "telephone_number": "803-776-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 RIDGE RD",
            "city": "HOPKINS",
            "state": "SC",
            "postal_code": "290618432",
            "telephone_number": "803-776-3873",
            "fax_number": "803-217-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDGEWOOD MANOR HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAVITRI",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "863-226-0358"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NF1109",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sedgewood Manor Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sedgewood Manor Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Hopkins, SC
• Providers in Hopkins, SC by specialty
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.

Verify at the official NPI Registry.