Liberty Healthcare Group LLC
Organization Active NPI Community Based Hospice Care Agency · Jacksonville, NC
NPI 1104995745 · NPPES record last updated May 5, 2010
Key facts
- NPI
- 1104995745
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- HOS2005 (NC)
- Legal business name
- LIBERTY HEALTHCARE GROUP LLC
- Practice address
- 1700 Country Club Rd
Jacksonville, NC 28546-6004 - Phone
- (910) 346-4800
- Fax
- (910) 346-5870
- NPI assigned
- Nov 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Anthony J. Zizzamia Jr., RN
- Title
- President/Executive Director
- Phone
- (910) 815-3122
Owners & managing parties with NPI records 1
Other NPIs on the same Medicare enrollment 13
Affiliated clinicians 43
-
Lior Abramson, MD
-
Tracy E Ayers, MD
-
Peggy S Barnhill, MD
-
Parul Dwijesh Bhagalia-Patel, M.B.B.S., MPH
-
Andrea Suzette Blackburn, M.D.
-
Christina Ritter Burton, PA-C
-
Varun Kumar Chukka, M.D
-
Crystal Gillis, FNP
-
Jose E Gonzalez, M.D.
-
Wesley James Greenwood, M.D.
-
Surah Grumet, MD
-
Imran Haque, M.D.
-
Brandie Nicole Jacobs, APRN FNP-C
-
Michael James, M.D.
-
Olajumoke Ladapo, MD
-
Kenneth Edward Locklear, M.D.
-
Rhonda Sanderson Lowry, M.D.
Medicare Care Compare: Hospice
- Listed as
- Liberty Home Care and Hospice
- Ownership
- For-Profit
- Certified
- Mar 29, 1994
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Hospice certification: CCN 341569
- Legal name
- LIBERTY HEALTHCARE GROUP LLC
- Doing business as
- LIBERTY HOME CARE AND HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 29, 1994
- Last certification
- May 25, 2022
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 7, 2002 in NC
- Enrollment address
- 420 Eastwood Rd
Ste 102
Wilmington, NC 28403-1866
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Sami Jo Taglieri |
W-2 Managing Employee |
Jun 1, 2025 | |
| Brandi Devane |
Operational/Managerial Control |
Jan 1, 2018 | |
| Home Care Management Services LLC |
Operational/Managerial Control | Oct 26, 2006 | |
| Ron Tatum |
W-2 Managing Employee |
Jun 28, 2025 | |
| Ariel Greenleaf |
W-2 Managing Employee |
Feb 10, 2025 | |
| Barbara Ring |
Operational/Managerial Control |
Oct 15, 2017 | |
| Kehinde Peralte |
W-2 Managing Employee |
Jan 29, 2024 | |
| Stephanie Adair |
Operational/Managerial Control |
Feb 28, 2022 | |
| Katrina Stanley |
W-2 Managing Employee |
Mar 24, 2024 | |
| Kristi Cannon |
W-2 Managing Employee |
Mar 10, 2024 | |
| John Albert McNeill |
5% Or Greater Direct Ownership Interest | Oct 1, 2008 | 50% |
| 5% Or Greater Indirect Ownership Interest | Oct 1, 2008 | 50% | |
| Donna Turlington |
W-2 Managing Employee |
Aug 1, 2023 | |
| Megan Vinson |
W-2 Managing Employee |
Aug 11, 2024 | |
| Liberty Homecare Group, LLC |
Operational/Managerial Control | Jun 7, 2002 | |
| Ronald Benjamin McNeill |
5% Or Greater Direct Ownership Interest | Oct 1, 2008 | 50% |
| 5% Or Greater Indirect Ownership Interest | Oct 1, 2008 | 50% | |
| Corporate Director | May 24, 2005 | ||
| W-2 Managing Employee | May 24, 2005 | ||
| Christopher Michael Wood |
W-2 Managing Employee |
Oct 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060109000110 | NC | Part a Provider - Hospice | 4587574355 |
13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wilmington, NC; Clinton, NC; Whiteville, NC; Wendell, NC; Supply, NC; Lumberton, NC; Jacksonville, NC; Hampstead, NC… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | HOS2005 | NC | Yes |
Addresses
Primary practice location
1700 Country Club Rd
Jacksonville, NC 28546-6004
Mailing address
2334 S 41St St
Wilmington, NC 28403-5502
Phone (910) 815-3122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007A | Other | NC | BLUE CROSS BLUE SHIELD |
| 3411569 | Medicaid | NC |
Other names
- Liberty Home Care, LLC
Other providers in Jacksonville, NC
- Madeline Jean Lewis
- Nora Rebecca Lewis
- Vanessa Stewart Lewis
- LHCG L, LLC
- Kurt Rommel Libed
- Liberty Healthcare Group, LLC
- Liberty Healthcare Group, LLC
- Liberty Nursing Services, LLC
- Janelle Libretto
- Erik James Lickteig
All providers in Jacksonville, NC · Community Based Hospice Care Agency in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.