PALMETTO SENIOR CARE SHANDON (NPI# 1801241971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801241971 |
| Entity Type | Organization |
| Organization Name | PALMETTO SENIOR CARE SHANDON |
| Practice Address |
1100 Shirley St Ste 1 Columbia SC 29205-1370 |
| Practice Telephone | 8032521979 |
| Mailing Telephone | 8032521979 |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |
| Authorized Official Name | DR. JOHN EGBERT (PACE EXECUTIVE MD) |
| Authorized Official Telephone | 8032521979 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | PALMETTO HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
19802 | SC | Nursing & Custodial Care Facilities |
| Street Address |
1100 SHIRLEY ST STE 1 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29205-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462241 | New Life Home Care LLC | In Home Supportive Care | 4423 Ste. D, Devine Street, Columbia, SC 29205 | 2019-11-25 |
| 1689144222 | Jessica M Jarman LLC | Counselor | 610 Holly St., Columbia, SC 29205 | 2018-11-27 |
| 1073083648 | Christopher James Troyer | Psychologist | 2805 Millwood Ave., Columbia, SC 29205 | 2018-11-27 |
| 1891277505 | Daniel Long | Pharmacist | 630 Kilbourne Road, Columbia, SC 29205 | 2018-08-30 |
| 1699126136 | Steven Matthew Ferrufino | Counselor | 417 S Edisto Ave, Columbia, SC 29205 | 2016-06-27 |
| 1619351863 | Deangela Lenore Delaney | Nurse Practitioner | 2739 Laurel Street, Columbia, SC 29205 | 2015-07-17 |
| 1548677131 | Maegan Elizabeth Dean | Pharmacist | 2708 Rosewood Drive, Columbia, SC 29205 | 2014-07-16 |
| 1144561465 | Abby Habicht | Speech-Language Pathologist | 705 Maple St., H 102, Columbia, SC 29205 | 2013-03-12 |
| 1750630562 | Pamela B. Robertson | Pharmacist | 3312 Devine Street, Columbia, SC 29205 | 2012-09-07 |
| 1609124023 | Kristen Anne Tice | Dietitian, Registered | 1029 Deerwood Street, Columbia, SC 29205 | 2012-08-15 |
| Find all providers in zip 29205 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868417 | Williams Community Care Home | Custodial Care Facility | 7705 Richard St, Columbia, SC 29209-3733 | 2020-10-13 |
| 1033658653 | Adult Day Health, Inc. | Custodial Care Facility | 9135 Guilford Rd Ste 100, Columbia, MD 21046-2579 | 2017-02-15 |
| 1508257080 | Complete Home Care Services of Tennessee | Custodial Care Facility | 2504 Cayer Ln Ste D, Columbia, TN 38401-7384 | 2015-02-05 |
| 1427480193 | Step By Step To Nursing | Custodial Care Facility | 237 Chartwell Rd, Columbia, SC 29210-5834 | 2013-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497314256 | The Barr Transition Place, LLC | Custodial Care Facility | 2422 Martin Luther King Jr Hwy, Kingstree, SC 29556-6945 | 2019-06-06 |
| 1265953590 | Club Horizons of Charleston, LLC | Custodial Care Facility | 8088 Rivers Ave, North Charleston, SC 29406-9235 | 2017-06-27 |
| 1720534985 | Caring Hearts Companions, LLC | Custodial Care Facility | 1185 Blanton Rd, Sharon, SC 29742-8752 | 2016-08-28 |
| 1295188001 | Professional Cleaning & Care Services LLC | Custodial Care Facility | 620 16th Ave S, Unit 89, Surfside Beach, SC 29575-3069 | 2016-07-16 |
| 1346634904 | Cheryl Renee Gibson-dalton | Custodial Care Facility | 1231 Eutaw St, Orangeburg, SC 29115-3529 | 2015-03-22 |
| 1447648001 | Carriage House Senior Living of Hartsville | Custodial Care Facility | 1131 E Home Ave, Hartsville, SC 29550-3411 | 2015-01-06 |
| 1881012177 | Joshua's Foundation Inc. | Custodial Care Facility | 388 Elbow Circle, Ridgeway, SC 29130-0035 | 2014-04-03 |
| 1013263433 | Hannah Residential Manor, Inc. | Custodial Care Facility | 3750 Sheminally Rd, Pamplico, SC 29583-5700 | 2012-08-03 |
| 1669776134 | New Generations Adult Day Center of Florence Inc | Custodial Care Facility | 2111 W. Jody Road, Florence, SC 29501 | 2010-12-27 |
| 1891941217 | Aaa Care, LLC | Custodial Care Facility | 6135 White Horse Rd Unit 143, Greenville, SC 29611-3832 | 2008-08-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.