Organization Active NPI

Bellarose Nursing and Rehab Center, Inc.

  • Skilled Nursing Facility
  • Garner, NC
National Provider Identifier
1093228397
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0654 Issued in NC
Legal business name
BELLAROSE NURSING AND REHAB CENTER, INC.
Practice address
200 Bellarose Lake Way
Garner, NC 27529-7049
Phone
(919) 985-8400
Fax
(919) 985-8399
NPI assigned
Nov 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Authorized official

Name
Robert G Evans
Title
President
Phone
(919) 985-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0654 NC Primary

Addresses

Primary practice location

200 Bellarose Lake Way
Garner, NC 27529-7049

Mailing address

PO Box 469
Garner, NC 27529-0469
Phone (919) 985-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180118002600 NC Part A Provider - Skilled Nursing Facility 7012276041 Practice locations: Garner, NC

Skilled nursing facility certification: CCN 345574

Legal name
BELLAROSE NURSING AND REHAB CENTER INC
Doing business as
BELLAROSE NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 29, 2018
Last certification
May 16, 2024
Beds
100
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Aug 1, 2011 in NC
Enrollment address
200 Bellarose Lake Way
Garner, NC 27529-7049
Nursing home name
BELLAROSE NURSING AND REHAB

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bellarose Nursing And RehabCCN 345574
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 29, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10092.2 residents per day on average

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
34D2141079Bellarose Nursing and Rehab Center, Inc200 Bellarose Lake Way, Garner, NC 27529Certificate of waiverDec 6, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Robert Gregory Evans Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011 12.5%
Corporate OfficerPresident Aug 1, 2011 12.5%
W-2 Managing EmployeePresident Aug 1, 2011
Operational/Managerial ControlPresident Aug 1, 2011
Rosemary Evans Miller Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011
Debbie Evans Sherrill Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011 25%
Riley Sarkey Evans Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011 12.5%
Corporate OfficerVP Aug 1, 2011 12.5%
Kisa Willis Evans Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011 12.5%
Corporate OfficerSecretary Aug 1, 2011 12.5%
W-2 Managing EmployeeSec/Treasurer Aug 1, 2011
Operational/Managerial ControlSec/Treasurer Aug 1, 2011
Sandra Richardson Individual W-2 Managing EmployeeDon Nov 17, 2017
Operational/Managerial ControlDon Oct 27, 2017
Justin Dixon Individual W-2 Managing EmployeeAdministrator Apr 9, 2018
Operational/Managerial ControlAdmin Apr 9, 2018
William Blue Miller Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011
Toni Corey Evans Individual 5% Or Greater Direct Ownership Interest12.5 Aug 1, 2011
Corporate OfficerAssistant Secretary Aug 1, 2011 12.5%
William Burroughs Individual W-2 Managing Employee Feb 24, 2018
Operational/Managerial ControlInterim Admin Feb 24, 2018

Practitioners & affiliated clinicians

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": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1093228397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275290469",
            "telephone_number": "919-985-8400",
            "fax_number": "919-985-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLAROSE LAKE WAY",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297049",
            "telephone_number": "919-985-8400",
            "fax_number": "919-985-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAROSE NURSING AND REHAB CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-985-8400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.