NPIMap

Organization Active NPI

Liberty Healthcare Group LLC

Doing business as Liberty Commons NRC of Johnston County

  • Skilled Nursing Facility
  • Benson, NC
National Provider Identifier
1093858458
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0606 Issued in NC
Legal business name
LIBERTY HEALTHCARE GROUP LLC
Doing business as
Liberty Commons NRC of Johnston County
Practice address
2315 Hwy 242 North
Benson, NC 27504-7820
Phone
(919) 207-1717
Fax
(919) 207-1529
NPI assigned
Feb 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joe Calcutt
Title
Cfo
Phone
(910) 332-1793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0606 NC Primary

Addresses

Primary practice location

2315 Hwy 242 North
Benson, NC 27504-7820

Mailing address

2334 S 41St St
Wilmington, NC 28403-5502
Phone (910) 815-3122

Other identifiers 1

IdentifierTypeStateIssuer
341613YMedicaidNC

Other names 1

  • Liberty Commons NRC of Johnston County Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093858458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 S 41ST ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122",
            "fax_number": "910-642-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 HWY 242 NORTH",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275047820",
            "telephone_number": "919-207-1717",
            "fax_number": "919-207-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALCUTT",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-332-1793"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341613Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Commons NRC of Johnston County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.