Active NPI
Wilkinson Care Center, Inc.
Doing business as Elderberry Health Care
- Skilled Nursing Facility
- Marshall, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH0479
- Legal business name
- WILKINSON CARE CENTER, INC.
- Doing business as
- Elderberry Health Care
- Practice address
- 415 Elderberry LN
Marshall, NC 28753-6369 - Phone
- (828) 252-1790
- Fax
- (828) 649-9348
- NPI assigned
- Mar 16, 2007
- Last updated
- Nov 6, 2012
- 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
- Edward Eller
- Title
- Controller
- Phone
- (336) 998-5001
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0479 | NC | Primary |
Addresses
Primary practice location
415 Elderberry LN
Marshall, NC 28753-6369
Mailing address
PO Box 1678
Clemmons, NC 27012-1678
Phone (336) 998-5001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3405319 | Medicaid | NC | |
| 3415319 | Medicaid | NC | |
| 3406576 | Medicaid | NC |
Other names 1
- Elderberry Health Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090514000072 | NC | Part A Provider - Skilled Nursing Facility | 3173672581 | Practice locations: Marshall, NC |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1265556294. Details of each certification follow.
Skilled nursing facility certification: CCN 345319
- Legal name
- WILKINSON CARE CENTER, INC.
- Doing business as
- ELDERBERRY HEALTH CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 14, 1990
- Last certification
- Aug 28, 2024
- Beds
- 100 (80 certified)
- Ownership / control type
- Corporation
- Multi-facility organization
- Wilkinson Care Center, Inc
- Organization structure
- Corporation
- Incorporated
- Jun 27, 1994 in NC
- Enrollment address
- 415 Elderberry Lane
Marshall, NC 28753-6369 - Nursing home name
- ELDERBERRY HEALTH CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Elderberry Health Care
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- May 14, 1990
- Medicare certification status
- Active
- Certified beds
- 80
National Provider Directory
National Provider Directory- Tax ID family
- Wilkinson Care Center Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Elderberry Health Care
- Assisted Living Facility
- Marshall, NC
- NPI 1578687232
Ownership & related parties
All disclosed owners & managing parties 12
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 |
|---|---|---|---|
| Charlotte Advance, Inc | 5% Or Greater Direct Ownership Interest | Jan 1, 2009 | 100% |
| Direct Ownership Interest | Jan 1, 2009 | 100% | |
| Adp of the SNF | Jul 7, 2025 | ||
| Elderberry of Marshall, LLC | 5% Or Greater Direct Ownership Interest | Sep 1, 2015 | 100% |
| Adp of the SNF | Sep 1, 2015 | ||
| Wilkinson Care Center, Inc. | Operational/Managerial Control | Jan 1, 2009 | |
| Andrew T. Martin | Operational/Managerial Control | Jul 25, 2022 | |
| Adp of the SNF | Jul 25, 2022 | ||
| Adp of the SNF | Jul 7, 2025 | ||
| Edward Eller | Corporate Officer | Jan 1, 2009 | |
| Operational/Managerial Control | May 14, 1990 | ||
| Adp of the SNF | May 14, 1990 | ||
| Karen S Cutshall | Operational/Managerial Control | Oct 1, 1993 | |
| Adp of the SNF | Oct 1, 1993 | ||
| Tullock Management Company | Operational/Managerial Control | May 14, 1990 | |
| Adp of the SNF | Jul 7, 2025 | ||
| James Martin | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 100% |
| Corporate Officer | Feb 16, 1998 | 100% | |
| Operational/Managerial Control | Oct 1, 2011 | ||
| Managing Control - Governing Body | Oct 1, 2011 | ||
| Adp of the SNF | Oct 1, 2011 | ||
| Indirect Ownership Interest | Oct 1, 2011 | 100% | |
| Adp of the SNF | Jul 7, 2025 | ||
| Adp of the SNF | Jul 7, 2025 |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Mars Hill, NC
- NPI 1043287766
-
- Internal Medicine Physician
- Marshall, NC
- NPI 1477916583
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": "1174003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352160000000",
"number": "1265556294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1678",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270121678",
"telephone_number": "336-998-5001",
"fax_number": "336-998-5470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 ELDERBERRY LN",
"city": "MARSHALL",
"state": "NC",
"postal_code": "287536369",
"telephone_number": "828-252-1790",
"fax_number": "828-649-9348"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILKINSON CARE CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-16",
"last_updated": "2012-11-06",
"status": "A",
"authorized_official_last_name": "ELLER",
"authorized_official_first_name": "EDWARD",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "336-998-5001"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "NH0479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3405319",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3415319",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3406576",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Elderberry Health Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marshall, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.