NPIMap

Organization Active NPI

Anderson Community Healthcare, LLC

Doing business as Linley Park Post Acute

  • Skilled Nursing Facility
  • Anderson, SC
National Provider Identifier
1750054094
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ANDERSON COMMUNITY HEALTHCARE, LLC
Doing business as
Linley Park Post Acute
Practice address
208 James St
Anderson, SC 29625-2942
Phone
(864) 226-3427
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

208 James St
Anderson, SC 29625-2942

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Linley Park 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
O20211101001499 SC Part A Provider - Skilled Nursing Facility 7810385473 Practice locations: Anderson, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750054094. Details of each certification follow.

Skilled nursing facility certification: CCN 425016

Legal name
ANDERSON COMMUNITY HEALTHCARE, LLC
Doing business as
LINLEY PARK POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jul 16, 2024
Beds
88
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS
Organization structure
LLCProprietary
Incorporated
Jun 29, 2021 in SC
Enrollment address
208 James St
Anderson, SC 29625-2942
Nursing home name
LINLEY PARK POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Linley Park Post AcuteCCN 425016 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8884.3 residents per day on average
Chain
Pacs Group274 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
42D0886460Linley Park Post Acute208 James St, Anderson, SC 29625Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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 5% Or Greater Indirect Ownership Interest Jun 29, 2021 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
David Jonathan Budhoo Individual Contracted Managing EmployeeMD; Jul 1, 2023
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Palmetto Community Healthcare, LLC Organization, Farmington, UT Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Jun 29, 2021 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Kevin C McCowan Individual W-2 Managing EmployeeAd; Oct 15, 2022
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 80

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

View all 80

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

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": "1750054094",
    "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": "208 JAMES ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296252942",
            "telephone_number": "864-226-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON COMMUNITY HEALTHCARE, 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": "Linley Park Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Linley Park Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.