NPIMap

Organization Active NPI

Autumn Care of Fayetteville, LLC

  • Skilled Nursing Facility
  • Fayetteville, NC
National Provider Identifier
1114463932
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
AUTUMN CARE OF FAYETTEVILLE, LLC
Practice address
1401 71St School Rd
Fayetteville, NC 28314-2814
Phone
(910) 867-4960
Fax
(910) 867-4980
NPI assigned
Jan 18, 2017
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
AUTUMN CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
William I Weisberg
Title
President
Phone
(216) 292-5706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1401 71St School Rd
Fayetteville, NC 28314-2814

Mailing address

23700 Commerce Park
Beachwood, OH 44122-5827
Phone (216) 292-5706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170330000082 NC Part A Provider - Skilled Nursing Facility 2668757881 Practice locations: Fayetteville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114463932. Details of each certification follow.

Skilled nursing facility certification: CCN 345553

Legal name
AUTUMN CARE OF FAYETTEVILLE, LLC
Doing business as
AUTUMN CARE OF FAYETTEVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 24, 2011
Last certification
Jan 9, 2025
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Autumn Corporation
Organization structure
LLCProprietary
Incorporated
Jan 11, 2017 in NC
Enrollment address
1401 71St School Road
Fayetteville, NC 28314-2814
Nursing home name
AUTUMN CARE OF FAYETTEVILLE
Affiliated entity
SABER HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Autumn Care of FayettevilleCCN 345553 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 24, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9086.0 residents per day on average
Chain
Saber Healthcare Group126 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Autumn Corporation

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Saber Healthcare Holdings LLC Organization, Beachwood, OH LLC, Holding company 5% Or Greater Indirect Ownership Interest Apr 1, 2017 100%
Adp of the SNF May 8, 2026
Barbara Collins Individual Operational/Managerial Control Sep 20, 2021
Adp of the SNF Sep 20, 2021
Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020) Organization, Beachwood, OH 5% Or Greater Indirect Ownership Interest Jan 1, 2023 33%
Ohi Asset (NC) Fayettevitte LP Organization, Hunt Valley, MD Real estate investment trust (REIT), Owned by another organization or individual 5% Or Greater Security Interest Apr 1, 2017 100%
Adp of the SNF Apr 1, 2017
Adebukola a Taiwo Individual Adp of the SNF Apr 1, 2017
Gregory Nicoluzakis Individual Corporate OfficerSecretary Mar 1, 2019
Adp of the SNF Mar 1, 2015
SHG Management LLC Organization, Beachwood, OH Operational/Managerial Control Sep 1, 2019
Adp of the SNF Sep 1, 2019
Saber Governance LLC Organization, Beachwood, OH LLC Adp of the SNF Sep 1, 2019
Saber Healthcare Group LLC Organization, Beachwood, OH LLC, Chain home office Adp of the SNF Apr 1, 2017
BNV Dynasty LLC Organization, Beachwood, OH LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2023 33%
Benjamin N Volpe Individual Corporate OfficerVice President and Treasurer Mar 1, 2019
Corporate DirectorVice President and Treasurer Mar 1, 2019 50%
Adp of the SNF Mar 1, 2019
SHG Autumn, LLC Organization, Beachwood, OH LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2017 100%
Adp of the SNF May 8, 2026
Citrin Cooperman Advisors LLC Organization, Woodmere, OH LLC Adp of the SNF Apr 1, 2017
Wiw Dynasty LLC Organization, Beachwood, OH LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2023 67%
William I Weisberg Individual Corporate OfficerPresident Mar 1, 2019
Corporate DirectorPresident Mar 1, 2019 50%
Cibc Bank USA Organization, Chicago, IL Financial institution Adp of the SNF Mar 31, 2021
Autumn Corporation Organization, Beachwood, OH Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2017 100%
Melissa Thompson Sullivan Individual Operational/Managerial Control Dec 17, 2023
Adp of the SNF Dec 17, 2023
Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020 Organization, Beachwood, OH 5% Or Greater Indirect Ownership Interest Jan 1, 2023 67%
SHG Mt, LLC Organization, Beachwood, OH LLC Adp of the SNF May 11, 2026

Owners & managing parties with NPI records 20

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 20

Facilities with the same owner 122

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

  • Autumn Care of Biscoe, LLC

    dba Autumn Care of Biscoe

    • Skilled Nursing Facility
    • Biscoe, NC
    • NPI 1255878245

    Autumn Corporation, Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw D

    CMS ownership
  • Autumn Care of Statesville, LLC

    dba Autumn Care of Statesville

    • Skilled Nursing Facility
    • Statesville, NC
    • NPI 1730722240

    Autumn Corporation, Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Nash

    • Skilled Nursing Facility
    • Nashville, NC
    • NPI 1053396788

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Myrtle Grove

    • Skilled Nursing Facility
    • Wilmington, NC
    • NPI 1073599635

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Marshville

    • Skilled Nursing Facility
    • Marshville, NC
    • NPI 1093791337

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Drexel

    • Skilled Nursing Facility
    • Morganton, NC
    • NPI 1275519506

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Shallotte

    • Skilled Nursing Facility
    • Shallotte, NC
    • NPI 1346226040

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Cornelius

    • Skilled Nursing Facility
    • Cornelius, NC
    • NPI 1376932889

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Salisbury

    • Skilled Nursing Facility
    • Salisbury, NC
    • NPI 1508842295

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Waynesville

    • Skilled Nursing Facility
    • Waynesville, NC
    • NPI 1528044294

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Marion

    • Skilled Nursing Facility
    • Marion, NC
    • NPI 1609852375

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, SHG Management LLC, Wiw Dynasty LLC

    CMS ownership
  • Autumn Corporation

    dba Autumn Care of Saluda

    • Skilled Nursing Facility
    • Saluda, NC
    • NPI 1639155302

    Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Autumn, LLC, Wiw Dynasty LLC

    CMS ownership
View all 122

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": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1114463932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23700 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225827",
            "telephone_number": "216-292-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 71ST SCHOOL RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142814",
            "telephone_number": "910-867-4960",
            "fax_number": "910-867-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN CARE OF FAYETTEVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUTUMN CORPORATION",
        "enumeration_date": "2017-01-18",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-292-5706"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.