NPIMap

Organization Active NPI

Lutheran Home - Forsyth County, Inc.

Doing business as Trinity Elms

  • Skilled Nursing Facility
  • Clemmons, NC
National Provider Identifier
1912323635
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LUTHERAN HOME - FORSYTH COUNTY, INC.
Doing business as
Trinity Elms
Practice address
7449 Fair Oaks Drive
Clemmons, NC 27012
Phone
(704) 637-2870
NPI assigned
Mar 6, 2014
Organization subpart
Yes
Parent organization
LUTHERAN SERVICES FOR THE AGING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Kesha L Smith
Title
Chief Operating Officer
Phone
(704) 637-2870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

7449 Fair Oaks Drive
Clemmons, NC 27012

Mailing address

7449 Fair Oaks Drive
Clemons, NC 27012

Other identifiers 1

IdentifierTypeStateIssuer
1912323635MedicaidNC

Other names 1

  • Trinity Elms Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140521001291 NC Part A Provider - Skilled Nursing Facility 3375766223 Practice locations: Clemmons, NC

Skilled nursing facility certification: CCN 345565

Legal name
LUTHERAN HOME - FORSYTH COUNTY, INC.
Doing business as
TRINITY ELMS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 13, 2014
Last certification
Jan 17, 2025
Beds
100
Ownership / control type
Church Related
Organization structure
CorporationNon-profit
Incorporated
Aug 28, 2008 in NC
Enrollment address
7449 Fair Oaks Drive
Clemmons, NC 27012
Nursing home name
TRINITY ELMS
Affiliated entity
LUTHERAN SERVICES CAROLINAS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Trinity ElmsCCN 345565 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Nov 13, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10090.8 residents per day on average
Chain
Lutheran Services Carolinas9 facilities in the chain
Penalties (3 years)
2Fines totaling $15,646

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
34D2083116Lutheran Home Forsyth County Dba Trinity Elms7449 Fair Oaks Drive, Clemmons, NC 27012Certificate of waiverAug 27, 2026

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
Cynthia D McCoy Individual Operational/Managerial Control Jun 26, 2023
Adp of the SNF Jun 26, 2003
Kesha L Smith Individual Corporate DirectorChief Operation Officer Sep 8, 2003
Operational/Managerial Control Oct 1, 2012
Adp of the SNF Oct 1, 2012
Lsa Elms Property, Inc Organization, Salisbury, NC Corporation, Non-profit Adp of the SNF Mar 16, 2025
Richard Herman Individual Managing Control - Governing BodyBoard Vice President Jun 1, 2022
Ted W Goins Individual Operational/Managerial Control Oct 1, 2004
Managing Control - Governing BodyTrustee President Oct 1, 2004
Trustee of the SNF Oct 1, 2004
Adp of the SNF Oct 1, 2004
Dawn P Owens-Watterson Individual Operational/Managerial Control May 3, 2023
Adp of the SNF May 3, 2023
Douglas E Nelson Individual Managing Control - Governing BodyBoard Chair Sep 1, 2022
Trustee of the SNF Sep 1, 2022
Karen Maddry Individual Corporate OfficerSecretary Jan 1, 2014
Lutheran Services for the Aging, Inc. Organization, Salisbury, NC Corporation, Non-profit Operational/Managerial Control Aug 28, 2008
Trustee of the SNF Aug 28, 2008
Kirby Nickerson Individual Corporate OfficerCfo Oct 1, 2012
Adp of the SNF Oct 1, 2012
Lsa Management, Inc. Organization, Salisbury, NC Corporation, Non-profit Operational/Managerial Control Aug 28, 2008 100%
Adp of the SNF Mar 16, 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 8

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.

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": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1912323635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7449 FAIR OAKS DRIVE",
            "city": "CLEMONS",
            "state": "NC",
            "postal_code": "27012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7449 FAIR OAKS DRIVE",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "27012",
            "telephone_number": "704-637-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME - FORSYTH COUNTY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN SERVICES FOR THE AGING, INC.",
        "enumeration_date": "2014-03-06",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KESHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "704-637-2870"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912323635",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Elms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.