Liberty Healthcare Group, LLC
Organization Active NPI Community Based Hospice Care Agency · Southern Pines, NC
NPI 1366529463 · NPPES record last updated Dec 22, 2009
Key facts
- NPI
- 1366529463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- HOS3050 (NC)
- Legal business name
- LIBERTY HEALTHCARE GROUP, LLC
- Practice address
- 300 W Pennsylvania Ave
Southern Pines, NC 28387-5445 - Phone
- (910) 692-7587
- Fax
- (910) 246-9885
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Anthony J Zizzamia Jr., RN
- Title
- President/Executive Director
- Phone
- (910) 815-3122
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 24
Affiliated clinicians 35
-
Chetan N Amin, DO
-
Holly Bernardini, DO
-
Kevin R Clark, DO
-
Thad Aaron Clements, M.D.
-
Amie N. Collins, MD
-
Amy Laura Delong, FNP
-
Michael D Gwinn, MD
-
Rebecca Myer Henderson, MD PHD
-
Cynthia Kupsick Honeycutt, ANP-BC
-
Michael James, M.D.
-
Rabi D Kutob, MD
-
William Long, M.D.
-
Garnett Marcus Lowry, M.D.
-
John Francis Lue Jr., M.D.
-
Rajan Mitchell, D.O.
-
Trina Dugger Prather, M.D.
Medicare Care Compare: Hospice
- Listed as
- Liberty Home Care II, LLC
- Ownership
- For-Profit
- Certified
- Nov 29, 1988
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Hospice certification: CCN 341537
- Legal name
- LIBERTY HEALTHCARE GROUP LLC
- Doing business as
- LIBERTY HOME CARE II, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 29, 1988
- Last certification
- Jun 16, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 7, 2002 in NC
- Enrollment address
- 336 S Main St
Raeford, NC 28376-3221
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Kimmie Fox |
Operational/Managerial Control |
Jun 22, 2014 | |
| Katherine Castello |
Operational/Managerial Control | Jan 29, 2024 | |
| Holly Macdonald |
W-2 Managing Employee |
Jul 1, 2019 | |
| Barbara Ring |
Operational/Managerial Control |
Apr 1, 2018 | |
| Brandy Harris |
Operational/Managerial Control |
Jul 25, 2021 | |
| Donna Turlington |
W-2 Managing Employee |
Aug 1, 2023 | |
| Ronald Benjamin McNeill |
5% Or Greater Direct Ownership Interest | Jul 1, 2002 | |
| Corporate Director | Jan 9, 2006 | ||
| W-2 Managing Employee | Jul 1, 2002 | ||
| Cheryl Dooley |
Operational/Managerial Control |
Jun 5, 2017 |
All facility ownership & control disclosures 29
| Facility | Type | Role | Since |
|---|---|---|---|
| Lee County Nursing and Rehabilitation Center, LLC |
Skilled nursing facility | Indirect Ownership Interest (100%) | Apr 29, 2025 |
| Liberty Commons Nursing and Rehabiltation Center of Lee County LLC |
Skilled nursing facility | Indirect Ownership Interest (100%) | Jun 6, 2025 |
| Liberty Healthcare Services of Golden Years Nursing Center LLC |
Skilled nursing facility | Indirect Ownership Interest (100%) | Apr 1, 2025 |
| Liberty Commons Nursing and Rehabilitation Center of Johnston County |
Skilled nursing facility | Indirect Ownership Interest (100%) | Apr 1, 2025 |
| Three Rivers Health and Rehabillitation Center |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Jun 25, 2025 |
| Liberty Commons Nursing and Rehabilitation Center of Rowan County, LLC |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) Indirect Ownership Interest (100%) |
Apr 4, 2025 Apr 4, 2025 |
| Liberty Commons Nursing and Rehabilitation Center of Wake County, LLC |
Skilled nursing facility | Adp of the SNF Indirect Ownership Interest (100%) |
Jul 22, 2025 Apr 29, 2025 |
| Liberty Healthcare Services of Southwood Nursing Center LLC |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Jun 25, 2025 |
| Liberty Healthcare Services of Mary Gran Nursing Center, LLC |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Jun 25, 2025 |
| Liberty Commons Nursing and Rehabilitation Center of Matthews LLC |
Skilled nursing facility | Adp of the SNF Indirect Ownership Interest (100%) |
Sep 29, 2025 Apr 1, 2025 |
| Shoreland Healthcare and Retirement Center |
Skilled nursing facility | Adp of the SNF | Mar 23, 2026 |
| Liberty Commons Nursing and Rehabilitation Center of the Oaks LLC |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest | May 1, 2011 |
| Summerstone Health and Rehab |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | May 1, 2012 |
| Woodlands Nursing and Rehabilitation Center |
Skilled nursing facility | Indirect Ownership Interest (100%) | Apr 29, 2025 |
| Liberty Healthcare Group LLC |
Skilled nursing facility | Indirect Ownership Interest | Apr 4, 2025 |
| Liberty Commons Nursing & Rehabilitation Center of Southport LLC |
Skilled nursing facility | Adp of the SNF Indirect Ownership Interest (100%) |
May 30, 2025 Apr 29, 2025 |
| Parkview Health & Rehab Center |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Apr 4, 2025 |
| Liberty Commons Nursing and Rehabilitation Center of Watauga County |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2019 |
| Louisburg Healthcare and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2020 |
| Liberty Commons Nursing and Rehabilitation Center of Yadkin County LLC |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2020 |
| Pinehurst Healthcare and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Apr 4, 2025 |
| Roxboro Healthcare and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2020 |
| Elizabethtown Healthcare and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) Indirect Ownership Interest (100%) |
Mar 31, 2025 Mar 31, 2025 |
| Oak Forest Health and Rehabilitation |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2021 |
| Highland House Rehabilitation and Healthcare |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Sep 30, 2022 |
| Woodhaven Nursing Center |
Skilled nursing facility | Adp of the SNF Indirect Ownership Interest (100%) |
Nov 20, 2024 Oct 1, 2023 |
| Silver Bluff |
Skilled nursing facility | Indirect Ownership Interest (100%) | Sep 5, 2024 |
| The Preserve at Fairfield Glade |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) | Oct 1, 2025 |
| Liberty Home Care II LLC |
Home health agency | 5% Or Greater Direct Ownership Interest | Jul 1, 2002 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060109000376 | NC | Part a Provider - Hospice | 4587574355 |
7 other NPIs on this enrollment Practice locations: Wadesboro, NC; Thomasville, NC; Southern Pines, NC; Siler City, NC; Sanford, NC; Raeford, NC; Dunn, NC; Smithfield, NC |
National Provider Directory
- Tax ID family
- Liberty Healthcare Group LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | HOS3050 | NC | Yes |
Addresses
Primary practice location
300 W Pennsylvania Ave
Southern Pines, NC 28387-5445
Mailing address
2334 S 41St St
Wilmington, NC 28403-5502
Phone (910) 815-3122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007CH | Other | NC | BLUE CROSS BLUE SHIELD |
| 3421537 | Medicaid | NC |
Other names
- Liberty Home Care II, LLC
Other providers in Southern Pines, NC
- Alice Brooke Leis
- Joy Marie Lemieux
- Angela Somers Leonard
- Jenny Lewellen Vaz
- Liberty Anesthesia, PLLC
- Liberty Healthcare Group, LLC
- Liberty Nursing Services II, LLC
- Life Wellness Counseling PLLC
- Lindsey Foreman Health Solutions PLLC
- Janay Lindsey
All providers in Southern Pines, NC · Community Based Hospice Care Agency 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 Dec 22, 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.