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COTTONWOOD VILLAS
NPI 1750578472
Assisted Living Facility in Bishopville, SC

Active since September 26, 2007CLIA 42D1003520 · Waiver
800 W CHURCH ST, BISHOPVILLE, SC 29010(803) 484-5303 Get Directions Write a Review

NPPES record last updated: September 26, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cottonwood Villas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COTTONWOOD VILLAS (NPI 1750578472) is a healthcare organization registered as an assisted living facility in Bishopville, South Carolina and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through September 2, 2026 and lists Richard C Cooke, President, as its authorized official.

NPPES Registry Identity

NPI1750578472
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOTTONWOOD VILLAS
Location Address800 W CHURCH STBishopville, SC 29010-1054
Mailing Address800 W Church StBishopville, SC 29010-1054
Phone(803) 484-5303
Organization SubpartNo
Authorized OfficialRichard C CookePresident · (843) 759-0025
Enumeration DateSeptember 26, 2007
✔ NPI 1750578472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in SC · RC1186
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
800 W CHURCH ST, Bishopville, SC 29010
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Other Identifiers 1

MedicaidRC1186SC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D1003520

Cottonwood Villas · Bishopville, SC
Active · expires Sep 2, 2026
CLIA Number42D1003520
Laboratory TypeOther
Certificate Effective DateSeptember 3, 2024
Certificate Expiration DateSeptember 2, 2026
Laboratory DirectorJohn Pate
Laboratory Phone(803) 484-5303
Laboratory LocationCottonwood Villas800 W Church St, Bishopville, SC 29010
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cottonwood Villas's NPI number?

The NPI number for Cottonwood Villas is 1750578472. It was assigned to this organization in the NPPES registry on September 26, 2007.

Where is Cottonwood Villas located?

Cottonwood Villas is located at 800 W Church St, Bishopville, SC 29010. The listed phone number is (803) 484-5303.

What is Cottonwood Villas's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Cottonwood Villas hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D1003520) is associated with this NPI, valid through September 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cottonwood Villas was last updated on September 26, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.