WILDEWOOD RETIREMENT LLC (NPI# 1619532801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619532801 |
| Entity Type | Organization |
| Organization Name | WILDEWOOD RETIREMENT LLC |
| Practice Address |
731 Polo Rd Columbia SC 29223-4462 |
| Mailing Address |
3530 Toringdon Way Ste 204 Charlotte NC 28277-3436 |
| Practice Telephone | 8037885115 |
| Mailing Telephone | 7042461620 |
| Mailing Fax Number | 7042461621 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | BENJAMIN THOMPSON (MANAGER) |
| Authorized Official Telephone | 7048157341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
731 POLO RD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-4462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134244387 | Elizabeth Taylor Adams | Physical Therapist | 731 Polo Rd, Columbia, SC 29223-4462 | 2007-03-20 |
| 1841823945 | Margaret A Mckinney | Occupational Therapist | 731 Polo Rd, Columbia, SC 29223-4462 | 2020-02-17 |
| 1265937700 | Haleigh Morgan Rioux | Occupational Therapist | 731 Polo Rd, Columbia, SC 29223-4462 | 2018-03-27 |
| 1053830810 | Kelsey Marie Odom | Physical Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2017-09-13 |
| 1346781127 | Sara Hibbs O'brien | Physical Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2017-03-14 |
| 1386093086 | Joseph Slagle | Physical Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2016-06-03 |
| 1710333877 | Chelsea Healey | Student in an Organized Health Care Education/Training Program | 731 Polo Rd, Columbia, SC 29223-4462 | 2016-05-09 |
| 1629437983 | Alison Eubanks Fogle | Physical Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2016-02-15 |
| 1558726885 | Joni Shirk Marino | Physical Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2015-12-31 |
| 1356713895 | Kyala King | Occupational Therapy Assistant | 731 Polo Rd, Columbia, SC 29223-4462 | 2015-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578088183 | Columbia Post Acute, LLC | Skilled Nursing Facility | 3535 Berrywood Dr, Columbia, MO 65201-6584 | 2017-08-04 |
| 1245786482 | Nhc-maury Regional Transitional Care Center LLC | Skilled Nursing Facility | 5010 Trotwood Ave, Columbia, TN 38401-4903 | 2016-08-28 |
| 1427436328 | Susquehanna Operator, LLC | Skilled Nursing Facility | 745 Old Chiques Hill Rd, Columbia, PA 17512-8401 | 2015-05-12 |
| 1356651772 | 2nd Generation Healthcare, LLC | Skilled Nursing Facility | 11 Pecan Drive, Columbia, MS 39429 | 2010-10-19 |
| 1013231794 | The Oaks of Blythewood, Inc. | Skilled Nursing Facility | 1075 Heather Green Drive, Columbia, SC 29229-0000 | 2010-03-24 |
| 1134455991 | Julie Williams | Skilled Nursing Facility | 3 Eagle Crest Court, Columbia, IL 62236 | 2009-10-28 |
| 1487836656 | Columbia Rehabilitation and Healthcare Center, LLC | Skilled Nursing Facility | 1506 N Main St, Columbia, MS 39429-2070 | 2007-11-29 |
| 1457483398 | Dorn Veterans Hospital | Skilled Nursing Facility | 3509 Lake Ave Apt 2132, Columbia, SC 29206-5111 | 2007-03-09 |
| 1659406668 | White Oak Manor Inc | Skilled Nursing Facility | 3001 Beechaven Rd, Columbia, SC 29204-2701 | 2007-02-22 |
| 1205961810 | Dynamic Columbia Operating Company LLC | Skilled Nursing Facility | 1506 North Main Street, Columbia, MS 39429-2070 | 2007-02-22 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on WILDEWOOD RETIREMENT LLC.
| 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.