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MYRTLE BEACH MANOR
NPI 1841245313
Skilled Nursing Facility in Myrtle Beach, SC

Active since May 23, 2006CLIA 42D0252116 · Waiver
2/5
Overall Rating
9547 HIGHWAY 17 NORTH, MYRTLE BEACH, SC 29572(843) 449-5283(843) 497-0880 Get Directions Write a Review

NPPES record last updated: March 27, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Myrtle Beach Manor NPPES

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

MYRTLE BEACH MANOR (NPI 1841245313) is a healthcare organization registered as a skilled nursing facility in Myrtle Beach, South Carolina and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Katherine E Potter, President & Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1841245313
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFS TENANT POOL I TRUST
Location Address9547 HIGHWAY 17 NORTHMyrtle Beach, SC 29572-4039
Mailing Address9547 Highway 17 NorthMyrtle Beach, SC 29572-4039
Phone(843) 449-5283
Fax(843) 497-0880
Organization SubpartYes
Authorized OfficialKatherine E PotterPresident & Chief Executive Officer · (617) 796-8387
Enumeration DateMay 23, 2006
Last NPPES UpdateMarch 27, 2019
✔ NPI 1841245313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in SC · NCF829
Definition
(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.
9547 HIGHWAY 17 NORTH, Myrtle Beach, SC 29572
Open in Google Maps ↗

Other Names 1

Doing Business AsMyrtle Beach Manor

Other Identifiers 1

Medicaid0829NFSC

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 42D0252116

Myrtle Beach Manor Healthcare · Myrtle Beach, SC
Active · expires Aug 31, 2026
CLIA Number42D0252116
Laboratory TypeSkilled Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorLarry Rast
Laboratory Phone(843) 449-5283
Laboratory LocationMyrtle Beach Manor Healthcare9547 Highway 17, Myrtle Beach, SC 29572
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Myrtle Beach Manor (CMS certification number 425070), from CMS Care Compare.

Myrtle Beach Manor

Nursing home · Myrtle Beach, SC
2/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number425070
Certified Beds60 beds33 residents per day on average
Medicare & Medicaid Participant SinceJuly 9, 1970
Resident & Family CouncilResident and family councils
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
3/5
Staffing
Based on nursing staff hours relative to resident needs.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
60.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.5 · LPN 0.86 · RN 0.97
4.32 hrs per resident per day
Weekend Nurse Staffing
4.04 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
63.6%
Registered Nurse Turnover
88.9%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
3
Substantiated Complaints
0
Infection-Control Citations
0
Fines
1 totaling $12,528.75
Medicare Payment Denials
1
Total Penalties
2
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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 Fs Tenant Pool I Trust's NPI number?

The NPI number for Fs Tenant Pool I Trust is 1841245313. It was assigned to this organization in the NPPES registry on May 23, 2006. The provider is doing business as Myrtle Beach Manor.

Where is Fs Tenant Pool I Trust located?

Fs Tenant Pool I Trust is located at 9547 Highway 17 North, Myrtle Beach, SC 29572. The listed phone number is (843) 449-5283.

What is Fs Tenant Pool I Trust's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Fs Tenant Pool I Trust hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D0252116) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Fs Tenant Pool I Trust a Medicare-certified nursing home?

Yes. Myrtle Beach Manor is a Medicare-certified nursing home with 60 certified beds.

What quality rating does Fs Tenant Pool I Trust have?

CMS rates Myrtle Beach Manor 2 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Fs Tenant Pool I Trust was last updated on March 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.