NPIMap

Organization Active NPI

Liberty Healthcare Group, LLC

  • Home Health Agency
  • Hampstead, NC
National Provider Identifier
1154376424
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC1241 Issued in NC
Legal business name
LIBERTY HEALTHCARE GROUP, LLC
Practice address
15235 US Highway 17 N
Hampstead, NC 28443-3790
Phone
(910) 251-8111
Fax
(910) 343-1218
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Authorized official

Name
Mr. Anthony Joseph Zizzamia Jr., RN
Title
Executive Director
Phone
(910) 815-3122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1241 NC Primary

Addresses

Primary practice location

15235 US Highway 17 N
Hampstead, NC 28443-3790

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
007AOtherNCBLUE CROSS BLUE SHIELD
3417001MedicaidNC

Other names 1

  • Liberty Home Care, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060501000069 NC Part A Provider - Home Health Agency 4587574355 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC; Hampstead, NC

Home health agency certification: CCN 347001

Legal name
LIBERTY HEALTHCARE GROUP LLC
Doing business as
LIBERTY HOME CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 14, 1966
Last certification
Apr 25, 2019
Ownership / control type
Proprietary
Organization structure
LLCNon-profit
Incorporated
Jan 1, 1994 in NC
Enrollment address
420 Eastwood Rd
Ste 101
Wilmington, NC 28403-1866

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Liberty Home Care, LLCCCN 347001
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jul 14, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Liberty Healthcare Group 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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Kristen Roberson Individual Operational/Managerial ControlHome Health Administrator Mar 21, 2023
Home Care Management Services LLC Organization, Wilmington, NC LLC Operational/Managerial Control Oct 26, 2006
John Albert McNeill Individual 5% Or Greater Direct Ownership Interest Jun 1, 2007 33%
5% Or Greater Indirect Ownership Interest Oct 1, 2008
Donna Turlington Individual W-2 Managing EmployeePresident of Home Care and Hospice Aug 1, 2024
Liberty Homecare Group, LLC Organization, Wilmington, NC LLC 5% Or Greater Direct Ownership Interest Jun 1, 2007 34%
Operational/Managerial Control Jun 7, 2002
Ronald Benjamin McNeill Individual 5% Or Greater Direct Ownership Interest Oct 1, 2008 33%
5% Or Greater Indirect Ownership Interest Oct 1, 2008
Corporate Director May 1, 2006

Practitioners & affiliated clinicians

Affiliated clinicians 23

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1154376424",
    "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": "910-815-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15235 US HIGHWAY 17 N",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433790",
            "telephone_number": "910-251-8111",
            "fax_number": "910-343-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "ZIZZAMIA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-815-3122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "007A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3417001",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Home Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.