Active NPI
Charlotte SP Senior Housing Opco, LLC
- Skilled Nursing Facility
- Charlotte, NC
National Provider Identifier
1124645544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CHARLOTTE SP SENIOR HOUSING OPCO, LLC
- Practice address
- 6041 Piedmont Row Drive
Charlotte, NC 28208 - Phone
- (980) 224-8540
- NPI assigned
- Jul 1, 2020
- 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
- Joseph V Calcutt
- Title
- Cfo
- Phone
- (910) 815-3122
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | |||
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
6041 Piedmont Row Drive
Charlotte, NC 28208
Mailing address
44 McNeill PLZ
Whiteville, NC 28472-8602
Phone (910) 642-0224
Other names 1
- BRIAR CREEK HEALTH CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210205000801 | NC | Part A Provider - Skilled Nursing Facility | 0648684456 | Practice locations: Charlotte, NC |
Skilled nursing facility certification: CCN 345578
- Legal name
- CHARLOTTE SP SENIOR HOUSING OPCO LLC
- Doing business as
- BRIAR CREEK HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Apr 19, 2021
- Last certification
- May 6, 2025
- Beds
- 136 (6 certified)
- Ownership / control type
- Corporation
- Organization structure
- Not Selected
- Enrollment address
- 6041 Piedmont Row Dr S
Charlotte, NC 28210-4967 - Nursing home name
- BRIAR CREEK HEALTH CENTER
- Affiliated entity
- LIBERTY SENIOR LIVING
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Briar Creek Health Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- Apr 19, 2021
- Medicare certification status
- Active
- Certified beds
- 6
- Chain
- Liberty Senior Living
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2207908 | Briar Creek Health Center | Certificate of waiver | Aug 16, 2027 |
National Provider Directory
National Provider DirectoryLocations
6041 Piedmont Row Dr S
Charlotte, NC 28210
Phone (704) 900-8539
Ownership & related parties
All disclosed owners & managing parties 17
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 |
|---|---|---|---|
| Karep V Senior Housing Reoc JV LLC | Other | Jul 24, 2018 | 100% |
| Barclay Developers Southpark, LLC | Other | Jul 24, 2018 | 11% |
| Liberty Real Properties VI LLC | Other | Jul 24, 2018 | 100% |
| Karep V SL Reit, LLC | Other | Jul 24, 2018 | 89.1% |
| Albert Rabil | Corporate Officer | Nov 1, 2020 | |
| John Wain | Corporate Officer | Nov 1, 2020 | |
| Jeffrey S. Wilson | Operational/Managerial Control | Nov 1, 2020 | |
| Kayne Anderson Real Estate Partners V LP (Karep V) | Other | Jul 24, 2018 | 100% |
| Senior Housing Intervening Company V LLC | Other | Jul 24, 2018 | 78% |
| Russell Reiter | Corporate Officer | Nov 1, 2020 | |
| Joseph V Calcutt | Operational/Managerial Control | Nov 1, 2020 | |
| Angela Carney | Operational/Managerial Control | Nov 1, 2020 | |
| David Sydney Selznick | Corporate Officer | Nov 1, 2020 | |
| Penny T. Purifoy | Operational/Managerial Control | Nov 1, 2020 | |
| Kayne Anderson Real Estate Partners V Parallel Fund LP | Other | Jul 24, 2018 | 100% |
| Karep V Parallel SL Reit LLC | Other | Jul 24, 2018 | 10.9% |
| Charlotte SP Senior Housing JV Opco, LLC | 5% Or Greater Direct Ownership Interest | Jul 24, 2018 | 100% |
| Operational/Managerial Control | Jul 24, 2018 | 100% |
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": "1593561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1593561600000",
"number": "1124645544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MCNEILL PLZ",
"city": "WHITEVILLE",
"state": "NC",
"postal_code": "284728602",
"telephone_number": "910-642-0224",
"fax_number": "910-642-8537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6041 PIEDMONT ROW DRIVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28208",
"telephone_number": "980-224-8540"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLOTTE SP SENIOR HOUSING OPCO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A",
"authorized_official_last_name": "CALCUTT",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "910-815-3122"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "BRIAR CREEK HEALTH CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.