NPIMap

Organization Active NPI

Wellmore of Lexington LLC

  • Skilled Nursing Facility
  • Lexington, SC
National Provider Identifier
1780114249
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WELLMORE OF LEXINGTON LLC
Practice address
200 Wellmore Drive
Lexington, SC 29072
Phone
(803) 520-1200
NPI assigned
Jun 18, 2017
Last updated
Jul 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Authorized official

Name
Mr. Donald O Thompson Jr.
Title
Ceo
Phone
(704) 246-1620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

200 Wellmore Drive
Lexington, SC 29072

Mailing address

3530 Toringdon Way
Ste 204
Charlotte, NC 28277
Phone (704) 246-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171215002723 SC Part A Provider - Skilled Nursing Facility 2264790468 Practice locations: Lexington, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780114249. Details of each certification follow.

Skilled nursing facility certification: CCN 425412

Legal name
WELLMORE OF LEXINGTON LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Apr 20, 2018
Last certification
May 22, 2025
Beds
60
Ownership / control type
Limited Liability Corporation
Multi-facility organization
SENIOR LIVING COMMUNITIES
Organization structure
LLCProprietary
Incorporated
Mar 6, 2012 in SC
Enrollment address
200 Wellmore Dr
Lexington, SC 29072-9172
Nursing home name
RETREAT AT WELLMORE OF LEXINGTON

Care Compare: Nursing home

Medicare Care Compare
Listed as
Retreat at Wellmore of LexingtonCCN 425412 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Apr 20, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6045.7 residents per day on average
Penalties (3 years)
1Fines totaling $16,153

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
42D2133974Wellmore Lexington200 Wellmore Drive, Lexington, SC 29072Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Crystal Pavlick Individual Adp of the SNF Sep 22, 2025
Jonathan T Macon Individual Adp of the SNF Sep 22, 2025
Benjamin M. Thompson Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2021 25%
Operational/Managerial Control Jul 1, 2022
Organization, Orlando, FL Real estate investment trust (REIT) Adp of the SNF Sep 1, 2016
Joshua E. Thompson Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2021 25%
Donald Thompson Individual 5% Or Greater Indirect Ownership Interest Jan 21, 2015 50%
Wellmore LLC Organization, Charlotte, NC Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Jan 21, 2015 100%
Maxwell Group, Inc. Organization, Charlotte, NC Management services company, Chain home office Operational/Managerial Control Sep 1, 2016
Adp of the SNF Feb 1, 2025

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 10

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1780114249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 TORINGDON WAY",
            "address_2": "STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-246-1620",
            "fax_number": "704-246-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WELLMORE DRIVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-520-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMORE OF LEXINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-246-1620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.