Active NPI
Laurel Crest Retirement Community
- Skilled Nursing Facility
- West Columbia, SC
National Provider Identifier
1558079525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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 CAROLINA
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NCF-1001 | Other | SC | DHEC |
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 |
|---|---|---|---|
| 42D0992250 | Laurel Crest Retirement Community | Certificate of waiver | Oct 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.