Organization Active NPI

Laurel Crest Retirement Community

  • Skilled Nursing Facility
  • West Columbia, SC
National Provider Identifier
1558079525
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAUREL CREST RETIREMENT COMMUNITY
Practice address
100 Joseph Walker Dr
West Columbia, SC 29169-6971
Phone
(803) 926-5271
Fax
(803) 791-1557
NPI assigned
Nov 9, 2022
Organization subpart
Yes
Parent organization
PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Kevin Johnson, CPA
Title
Chief Financial Officer
Phone
(803) 365-0855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

100 Joseph Walker Dr
West Columbia, SC 29169-6971

Mailing address

2817 Ashland Rd
Columbia, SC 29210-5009
Phone (803) 365-0854

Other identifiers 1

IdentifierTypeStateIssuer
NCF-1001OtherSCDHEC

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
42D0992250Laurel Crest Retirement Community100 Joseph Walker Dr, West Columbia, SC 29169Certificate of waiverOct 10, 2027

National Provider Directory

National Provider Directory
Part of
Presbyterian Communities of South Carolina

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1558079525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ASHLAND RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105009",
            "telephone_number": "803-365-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOSEPH WALKER DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291696971",
            "telephone_number": "803-926-5271",
            "fax_number": "803-791-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL CREST RETIREMENT COMMUNITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN COMMUNITIES OF SOUTH CAROLINA",
        "enumeration_date": "2022-11-09",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-365-0855",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHEC",
            "identifier": "NCF-1001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.