NPIMap

Organization Active NPI

Liberty Healthcare Group, LLC

  • Skilled Nursing Facility
  • Candler, NC
National Provider Identifier
1073034138
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LIBERTY HEALTHCARE GROUP, LLC
Practice address
104 Holcombe Cove Rd
Candler, NC 28715-9452
Phone
(828) 667-9851
NPI assigned
Jun 29, 2017
Last updated
Jun 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Joseph V Calcutt
Title
Cfo
Phone
(910) 815-3122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NC Primary

Addresses

Primary practice location

104 Holcombe Cove Rd
Candler, NC 28715-9452

Mailing address

44 McNeill PLZ
Whiteville, NC 28472-8602
Phone (910) 642-0224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180330000385 NC Part A Provider - Skilled Nursing Facility 4587574355 Practice locations: Candler, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073034138. Details of each certification follow.

Skilled nursing facility certification: CCN 345393

Legal name
LIBERTY HEALTHCARE GROUP LLC
Doing business as
PISGAH MANOR HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 16, 1991
Last certification
Apr 1, 2025
Beds
118
Ownership / control type
Corporation
Multi-facility organization
Liberty Healthcare
Organization structure
LLCProprietary
Enrollment address
104 Holcombe Cove Rd
Candler, NC 28715-9452
Nursing home name
PISGAH MANOR HEALTH CARE CENTER
Affiliated entity
LIBERTY SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pisgah Manor Health Care CenterCCN 345393 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 16, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
118105.2 residents per day on average
Chain
Liberty Senior Living37 facilities in the chain
Penalties (3 years)
1Fines totaling $59,391

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
34D0247562Pisgah Manor Health Care Center104 Holcombe Cove Rd, Candler, NC 28715Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Liberty Nursing Services II LLC119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

95 Holcombe Cove Rd
Candler, NC 28715
Phone (828) 667-9851

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey S. Wilson Individual Corporate OfficerCoo Mar 10, 2011 100%
Operational/Managerial ControlCoo Mar 10, 2011 100%
Michelle Grandy Individual Operational/Managerial Control Aug 3, 2009
John Albert McNeill Individual 5% Or Greater Indirect Ownership InterestMember/Manager Mar 10, 2011 50%
Operational/Managerial ControlMember/Manager Mar 10, 2011 50%
Joseph V Calcutt Individual Corporate OfficerCfo Mar 10, 2011 100%
Operational/Managerial ControlCfo Mar 10, 2011 100%
Penny T. Purifoy Individual Corporate DirectorDirector of Ar - LTC Management Mar 10, 2011 100%
Operational/Managerial ControlDirector of Ar, LTC Managment Mar 10, 2011 100%
Long Term Care Management Services LLC Organization, Wilmington, NC LLC 5% Or Greater Direct Ownership Interest Mar 10, 2011 100%
Operational/Managerial Control Mar 10, 2011 100%
Robert B Miller Individual Corporate DirectorSenior Director of Revenue Cycle Sep 1, 2024
Ronald Benjamin McNeill Individual 5% Or Greater Indirect Ownership InterestMember/Manager Mar 10, 2011 50%
Operational/Managerial ControlMember/Manager Mar 10, 2011 50%

All facility ownership & control disclosures 29

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lee County Nursing and Rehabilitation Center, LLCSanford, NC, CCN 345216 Skilled nursing facility Indirect Ownership Interest (100%) Apr 29, 2025
Liberty Commons Nursing and Rehabiltation Center of Lee County LLCSanford, NC, CCN 345532 Skilled nursing facility Indirect Ownership Interest (100%) Jun 6, 2025
Liberty Healthcare Services of Golden Years Nursing Center LLCFalcon, NC, CCN 345367 Skilled nursing facility Indirect Ownership Interest (100%) Apr 1, 2025
Liberty Commons Nursing and Rehabilitation Center of Johnston CountyBenson, NC, CCN 345519 Skilled nursing facility Indirect Ownership Interest (100%) Apr 1, 2025
Three Rivers Health and Rehabillitation CenterWindsor, NC, CCN 345404 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jun 25, 2025
Liberty Commons Nursing and Rehabilitation Center of Rowan County, LLCSalisbury, NC, CCN 345503 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%)
Indirect Ownership Interest (100%)		 Apr 4, 2025
Apr 4, 2025
Liberty Commons Nursing and Rehabilitation Center of Wake County, LLCRaleigh, NC, CCN 345202 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (100%)		 Jul 22, 2025
Apr 29, 2025
Liberty Healthcare Services of Southwood Nursing Center LLCClinton, NC, CCN 345472 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jun 25, 2025
Liberty Healthcare Services of Mary Gran Nursing Center, LLCClinton, NC, CCN 345218 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jun 25, 2025
Liberty Commons Nursing and Rehabilitation Center of Matthews LLCMatthews, NC, CCN 345026 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (100%)		 Sep 29, 2025
Apr 1, 2025
Shoreland Healthcare and Retirement CenterWhiteville, NC, CCN 345397 Skilled nursing facility Adp of the SNF Mar 23, 2026
Liberty Commons Nursing and Rehabilitation Center of the Oaks LLCWinston-Salem, NC, CCN 345284 Skilled nursing facility 5% Or Greater Direct Ownership Interest May 1, 2011
Summerstone Health and RehabKernersville, NC, CCN 345039 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) May 1, 2012
Woodlands Nursing and Rehabilitation CenterFayetteville, NC, CCN 345481 Skilled nursing facility Indirect Ownership Interest (100%) Apr 29, 2025
Liberty Healthcare Group LLCWarrenton, NC, CCN 345240 Skilled nursing facility Indirect Ownership Interest Apr 4, 2025
Liberty Commons Nursing & Rehabilitation Center of Southport LLCSouthport, NC, CCN 345373 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (100%)		 May 30, 2025
Apr 29, 2025
Parkview Health & Rehab CenterChapel Hill, NC, CCN 345576 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Apr 4, 2025
Liberty Commons Nursing and Rehabilitation Center of Watauga CountyBlowing Rock, NC, CCN 345045 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2019
Louisburg Healthcare and Rehabilitation CenterLouisburg, NC, CCN 345358 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2020
Liberty Commons Nursing and Rehabilitation Center of Yadkin County LLCYadkinville, NC, CCN 345167 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2020
Pinehurst Healthcare and Rehabilitation CenterPinehurst, NC, CCN 345370 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Apr 4, 2025
Roxboro Healthcare and Rehabilitation CenterRoxboro, NC, CCN 345311 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2020
Elizabethtown Healthcare and Rehabilitation CenterElizabethtown, NC, CCN 345210 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%)
Indirect Ownership Interest (100%)		 Mar 31, 2025
Mar 31, 2025
Oak Forest Health and RehabilitationWinston Salem, NC, CCN 345443 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2021
Highland House Rehabilitation and HealthcareFayetteville, NC, CCN 345353 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Sep 30, 2022
Woodhaven Nursing CenterLumberton, NC, CCN 345054 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (100%)		 Nov 20, 2024
Oct 1, 2023
Silver BluffCanton, NC, CCN 345341 Skilled nursing facility Indirect Ownership Interest (100%) Sep 5, 2024
The Preserve at Fairfield GladeCrossville, TN, CCN 445506 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2025
Liberty Home Care II LLCSouthern Pines, NC, CCN 347024 Home health agency 5% Or Greater Direct Ownership Interest Jul 1, 2002

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1073034138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MCNEILL PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284728602",
            "telephone_number": "910-642-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HOLCOMBE COVE RD",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287159452",
            "telephone_number": "828-667-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "CALCUTT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-815-3122"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Candler, NC

Sources for this page

Verify at the official NPI Registry.