Active NPI
Carolina Cumberland Operator LLC
- Skilled Nursing Facility
- Fayetteville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CAROLINA CUMBERLAND OPERATOR LLC
- Practice address
- 4600 Cumberland Rd
Fayetteville, NC 28306-2412 - Phone
- (910) 429-1690
- NPI assigned
- May 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cindy Maher
- Title
- Administrator
- Phone
- (910) 429-1690
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
4600 Cumberland Rd
Fayetteville, NC 28306-2412
Mailing address
4600 Cumberland Rd
Fayetteville, NC 28306-2412
Other names 1
- Carolina Rehab Center of Cumberland
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210823003273 | NC | Part A Provider - Skilled Nursing Facility | 6901201383 | Practice locations: Fayetteville, NC |
Skilled nursing facility certification: CCN 345505
- Legal name
- CAROLINA CUMBERLAND OPERATOR LLC
- Doing business as
- CAROLINA REHABW CENTER OF CUMBERLAND
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 26, 2000
- Last certification
- Jul 2, 2025
- Beds
- 136
- Ownership / control type
- Corporation
- Multi-facility organization
- Medical Facilities of America
- Organization structure
- LLC
- Incorporated
- Mar 23, 2021 in NV
- Enrollment address
- 4600 Cumberland Rd
Fayetteville, NC 28306-2412 - Nursing home name
- CAROLINA REHAB CENTER OF CUMBERLAND
- Affiliated entity
- LIFEWORKS REHAB
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Carolina Rehab Center of Cumberland
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 26, 2000
- Medicare certification status
- Active
- Certified beds
- 136
- Chain
- Lifeworks Rehab
- Penalties (3 years)
- 5
National Provider Directory
National Provider DirectoryLocations
4600 Cumberland Rd
Fayetteville, NC 28306
Phone (910) 429-1690
Ownership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lauren 2020 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| Springrock South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 75% |
| Norman 5571 & Family LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| RL 2008 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 10% |
| Charles 1994 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 21.37% |
| Lauren 2020 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Rsbrm South Manager LLC | Operational/Managerial Control | May 28, 2021 | 100% |
| Norman 5571 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 21.37% |
| Norman 5571 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.49% |
| Saul 2012 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Leps 2003 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 10% |
| Cindy Maher | W-2 Managing Employee | May 28, 2021 | 100% |
| DRM South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 25% |
| Carolina Cumberland Holdings LLC | 5% Or Greater Direct Ownership Interest | May 28, 2021 | 100% |
| Robin 2008 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| CK 2008 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 5% |
| Edward 1998 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Robin 2008 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Summer South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 100% |
Facilities with the same owner 37
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Burlington, NC
- NPI 1114501442
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, RL 20
-
- Skilled Nursing Facility
- Gastonia, NC
- NPI 1316512346
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, Norma
-
- Skilled Nursing Facility
- Connelly Springs, NC
- NPI 1144804485
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, Norman 5571 LLC, RL 2008 Family Trust ·
-
- Skilled Nursing Facility
- Charlotte, NC
- NPI 1194309336
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, Norma
-
- Skilled Nursing Facility
- Greensboro, NC
- NPI 1033784970
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 LLC, RL 2008 Family Trust, Robin 2008 LLC, Rsbrm South Manag
-
- Skilled Nursing Facility
- Huntersville, NC
- NPI 1477137628
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, Norma
-
- Skilled Nursing Facility
- Lexington, NC
- NPI 1083298236
Charles 1994 Family Grantor Trust, CK 2008 Family Trust, DRM South LLC, Edward 1998 Family Grantor Trust, Lauren 2020 Family Grantor Trust, Lauren 2020 LLC, Leps 2003 Family Trust, Norman 5571 & Family LLC, Norman 5571 Family Grantor Trust, Norma
-
- Skilled Nursing Facility
- Charlottesville, VA
- NPI 1003490277
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Appomattox, VA
- NPI 1639753809
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Virginia Beach, VA
- NPI 1528642790
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust
-
- Skilled Nursing Facility
- Richmond, VA
- NPI 1508440785
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Vinton, VA
- NPI 1861076044
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Fayetteville, NC
- NPI 1114917770
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": "1620777600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620777600000",
"number": "1114501459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 CUMBERLAND RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283062412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 CUMBERLAND RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283062412",
"telephone_number": "910-429-1690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROLINA CUMBERLAND OPERATOR LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-12",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A",
"authorized_official_last_name": "MAHER",
"authorized_official_first_name": "CINDY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "910-429-1690"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Carolina Rehab Center of Cumberland",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.