NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting

Doing business as Veteran Village

  • Skilled Nursing Facility
  • Florence, SC
National Provider Identifier
1902476443
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING
Doing business as
Veteran Village
Practice address
1200 E National Cemetery Rd
Florence, SC 29506-3239
Phone
(843) 432-4600
NPI assigned
Jun 28, 2021
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Deborah S Blalock
Title
Director
Phone
(803) 898-8461

Specialties & licenses 1

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

Addresses

Primary practice location

1200 E National Cemetery Rd
Florence, SC 29506-3239

Mailing address

2414 Bull St
Columbia, SC 29201-1906
Phone (803) 898-8523

Other names 1

  • Veteran Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071217000080 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 5 practitioners
3 other NPIs on this enrollment
Practice locations: Anderson, SC; Florence, SC; Gaffney, SC; Walterboro, SC

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pee Dee Mental Health C61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Carolina Dept of Mental Health Accounting OfficeColumbia, SC, CCN 424005 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1978
Patrick B Harris Psychiatric HospitalAnderson, SC, CCN 424011 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 7, 2016
Dec 29, 1986
CM Tucker Jr Nursing CareColumbia, SC, CCN 425074 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1970
Jan 1, 1970
C.M. Tucker Jr Nursing Care Center-Roddey PavillionColumbia, SC, CCN 425360 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jan 1, 2006

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1902476443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 BULL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011906",
            "telephone_number": "803-898-8523",
            "fax_number": "803-898-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E NATIONAL CEMETERY RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295063239",
            "telephone_number": "843-432-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-898-8461"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Veteran Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.