Sunbridge Retirement Care Associates LLC
Organization Active NPI Skilled Nursing Facility · Pembroke, NC
NPI 1194779504 · NPPES record last updated Sep 29, 2009
Key facts
- NPI
- 1194779504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH0518 (NC)
- Legal business name
- SUNBRIDGE RETIREMENT CARE ASSOCIATES LLC
- Practice address
- 310 E Wardell Rd
Pembroke, NC 28372-7997 - Phone
- (910) 521-1273
- Fax
- (910) 521-3593
- NPI assigned
- May 20, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SUNBRIDGE HEALTHCARE CORPORATION
Authorized official
- Name
- William A. Mathies
- Title
- President Director
- Phone
- (505) 821-3355
Owners & managing parties with NPI records 8
-
Jeffrey D Seder, M.D.
Owned or controlled facilities with NPI records 1
Member of 1
Member organizations 16
Facilities with the same owner 179
Practitioners 2
-
Jeffrey D Seder, M.D.
Affiliated clinicians 3
-
Jeffrey D Seder, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Pembroke Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 7, 1992
- Medicare certification status
- Active
- Certified beds
- 84 · 67.6 residents per day on average
- Chain
- Genesis Healthcare
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 3 · fines totaling $37,339
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Skilled nursing facility certification: CCN 345409
- Legal name
- SUNBRIDGE RETIREMENT CARE ASSOCIATES, LLC
- Doing business as
- PEMBROKE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 7, 1992
- Last certification
- Nov 20, 2024
- Beds
- 84
- Ownership / control type
- Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Mar 24, 1986 in CO
- Enrollment address
- 310 E Wardell Rd
Pembroke Care and Rehabilitation Center
Pembroke, NC 28372-7997 - Nursing home name
- PEMBROKE CENTER
- Affiliated entity
- GENESIS HEALTHCARE
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Laura Bridgeford |
Corporate Officer |
Jan 1, 2024 | 100% |
| HCCF Management Group XI LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 70.8% |
| Gen Operations I LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2012 | 100% |
| Powerback Rehabilitation LLC |
Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | Feb 4, 2025 | ||
| Gen Operations II LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2012 | 100% |
| Sun Healthcare Group, Inc. |
5% Or Greater Indirect Ownership Interest | Feb 1, 2020 | 65.3% |
| FC Gen Operations Investment LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2012 | 100% |
| Jeffrey D Seder |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Feb 4, 2025 | ||
| Genesis Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2012 | 100% |
| Syreeta Parham |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Feb 4, 2025 | ||
| Genesis Administrative Services LLC |
Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | Feb 4, 2025 | ||
| Welltower Op, LLC |
5% Or Greater Indirect Ownership Interest | Feb 1, 2025 | 5.7% |
| Arnold M Whitman |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 5.7% |
| Genesis Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Zac Properties XI LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 7.6% |
| Steven E Fishman |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 7.6% |
| Avi Pinchas Mendelson |
Corporate Officer |
Jan 1, 2024 | 100% |
| Michael T Berg |
Corporate Officer |
Dec 1, 2012 | |
| Sunbridge Healthcare LLC |
5% Or Greater Direct Ownership Interest | Feb 1, 2009 | 100% |
| Genesis Holdings LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Magnolia Ridge |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 15, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090325000695 | NC | Part a Provider - Skilled Nursing Facility | 7416030135 | Practice locations: Pembroke, NC |
National Provider Directory
- Part of
- Terrace Hghts Nursing H
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0518 | NC | Yes |
Addresses
Primary practice location
310 E Wardell Rd
Pembroke, NC 28372-7997
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0088K | Other | NC | BCBS |
| 341600N | Medicaid | NC | |
| 17968 | Other | NC | PARTNERS |
| 3415409 | Medicaid | NC | |
| 345409 | Other | MEDCOST/MULTIPLAN | |
| 71-08310 | Other | UNITED HEALTHCARE | |
| 0088K | Other | NC | STATE BCBS |
Other names
- Pembroke Care and Rehabilitation Center
Other providers in Pembroke, NC
- Matthew Lee Stephens
- Amy Dawn Strickland
- Sierra Jo Strickland
- Jessica Oxendine Strong
- Charlamane Carter Suggs
- T & L Empowerment, LLC.
- Take Flight Associates Inc
- Take Flight Services LLC
- Joseph Tamburo
- Tender Hearts Homecare LLC
All providers in Pembroke, NC · Skilled Nursing Facility 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 Sep 29, 2009. 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.