Premier Living and Rehab Center

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

PREMIER LIVING AND REHAB CENTER

Practice address

106 Cameron St
Lake Waccamaw, NC 28450-1900

Phone

(910) 646-3132

Fax

(910) 646-4071

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Benton Parnell, LNHA

Title

Administrator

Phone

(910) 646-3132

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Skilled nursing facility certification: CCN 345185

Legal name

PREMIER LIVING AND REHAB CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 29, 1978

Last certification

Jul 2, 2024

Beds

142 (127 certified)

Ownership / control type

Individual

Organization structure

LLCProprietary

Enrollment address

106 Cameron Street
Lake Waccamaw, NC 28450-0196

Listed as

Premier Living and Rehab CenterCCN 345185

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Sep 29, 1978

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12767.4 residents per day on average

Special focus status

SFF Candidate

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

4Fines totaling $383,791

Processed by Care Compare on Aug 1, 2026.

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.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy E Ayers, MD

  • Family Medicine Physician
  • Morehead City, NC
  • NPI 1447203229
  NPD (past)
• Gregorio Jacob, M.D.

  • Specialist
  • Goldsboro, NC
  • NPI 1558325811
  NPD (past)
• David M Chess, M.D.

  • Internal Medicine Physician
  • Stratford, CT
  • NPI 1376521773
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Gregorio Jacob, M.D.

  • Specialist
  • Goldsboro, NC
  • NPI 1558325811

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1720085293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CAMERON ST",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284501900",
            "telephone_number": "910-646-3132",
            "fax_number": "910-646-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CAMERON ST",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284501900",
            "telephone_number": "910-646-3132",
            "fax_number": "910-646-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER LIVING AND REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "PARNELL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "BENTON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-646-3132",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0246",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "NC",
            "license": "5030990001",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NC",
            "license": "5030990001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3435185",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3436171",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804320",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Waccamaw Primary Care, PLLC
• De'Voncia Lachel Mickins
• New Opportunities of Columbus Co.
• Danielle Nicole Poteat, LCSWA
• Premier Living and Healthcare Center LLC
• Amy Lawson Richardson, LCSW
• Thompson Child & Family Focus
• Thompson Child & Family Focus
• Town of Lake Waccamaw
• Stephanie Anne Tucker, LCSWA

• All providers in Lake Waccamaw, NC
• Nursing Facility/Intermediate Care Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.