NPIMap

Organization Active NPI

Rex Hospital, Inc.

Doing business as UNC REX Rehabilitation & Nursing Care Center of Raleigh

  • Skilled Nursing Facility
  • Raleigh, NC
National Provider Identifier
1376542878
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
H0065 Issued in NC
Legal business name
REX HOSPITAL, INC.
Doing business as
UNC REX Rehabilitation & Nursing Care Center of Raleigh
Practice address
4210 Lake Boone TRL
Raleigh, NC 27607-6521
Phone
(919) 784-6600
Fax
(919) 784-6623
NPI assigned
Jul 18, 2005
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Mr. Benjamin James Mathew
Title
Cfo
Phone
(919) 784-1440

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X H0065 NC
Nursing Facility/Intermediate Care Facility 313M00000X H0065 NC
Skilled Nursing Facility 314000000X H0065 NC Primary

Addresses

Primary practice location

4210 Lake Boone TRL
Raleigh, NC 27607-6521

Mailing address

4210 Lake Boone TRL
Raleigh, NC 27607-6521
Phone (919) 784-6600

Other identifiers 10

IdentifierTypeStateIssuer
AN4793114001OtherNCCIGNA HEALTHCARE
33015OtherNCPARTNERS
0093UOtherNCBLUE CROSS OF NC
3416062MedicaidNC
0093UOtherNCSTATE HEALTH PLAN OF NC
7152480OtherNCUNITED HEALTHCARE
XXXXXXXX9260OtherNEAARP
7152480OtherNCUNITED MEDICARE COMPLETE
119744OtherNCWELLPATH
3415369MedicaidNC

Other names 1

  • UNC REX Rehabilitation & Nursing Care Center of Raleigh Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090213000243 NC Part A Provider - Skilled Nursing Facility 0840109864 Practice locations: Raleigh, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376542878. Details of each certification follow.

Skilled nursing facility certification: CCN 345369

Legal name
REX HOSPITAL INC
Doing business as
UNC REX REHABILITATION & NURSING CARE CENTER OF RALEIGH
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 21, 1991
Last certification
May 17, 2024
Beds
120
Ownership / control type
Hospital District
Multi-facility organization
UNC Rex Healthcare
Organization structure
CorporationNon-profit
Incorporated
Mar 17, 1986 in NC
Enrollment address
4210 Lake Boone TRL
Raleigh, NC 27607-6521
Nursing home name
REX REHAB & NURSING CARE CENTER

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rex Rehab & Nursing Care CenterCCN 345369 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
May 21, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120101.7 residents per day on average
Penalties (3 years)
1Fines totaling $15,646

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0713055Rex Rehab and Nursing Care Center4210 Lake Boone Trail, Raleigh, NC 27607Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Rex Outreach16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 29

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

NameRoleSinceShare
Tammy Scarborough Individual Corporate DirectorBoard Member Mar 4, 2025
Caryn Coppedge McNeill Individual Corporate DirectorBoard Member May 5, 2025
The New Trustees of the Rex Hospital Inc Organization, Morrisville, NC Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 16, 1986 100%
Adp of the SNF Mar 16, 1986
Dayatra Tishaun Matthews Individual Corporate DirectorBoard Member May 5, 2025
Catharine Biggs Arrowood Individual Corporate DirectorBoard of Directors Jan 24, 2014
William Robert Bryant Individual Corporate DirectorBoard Member Jan 4, 2024
Lynne Fiscus Individual Corporate DirectorBoard Member Apr 20, 2021
Steven M Liebowitz Individual Operational/Managerial Control Jul 1, 1991
Adp of the SNF Jul 1, 1991
Robert Bradford Oakes Individual Corporate DirectorBoard of Directors Jan 1, 2021
University of North Carolina Health Care System Organization, Morrisville, NC Chain home office 5% Or Greater Indirect Ownership Interest Apr 1, 2000 100%
Adp of the SNF Apr 1, 2000
Tanya E Zinner Individual Operational/Managerial Control Mar 1, 2007
Adp of the SNF Mar 1, 2007
David Mills Individual Corporate DirectorBoard of Directors Jan 1, 2021
Jeffrey Todd Lindsay Individual Corporate DirectorBoard Member Dec 26, 2023
Matthew G Ewend Individual Corporate DirectorBoard Member Jul 22, 2019
Michael Chad Setliff Individual Corporate Officer Oct 28, 2024
Corporate Director Oct 28, 2024
Nedra Lashawn Hobbs Individual Operational/Managerial Control Apr 13, 2025
Adp of the SNF Apr 13, 2025
Jason Thomas Sandner Individual Corporate DirectorBoard of Directors Jan 1, 2019
Kevin Tyler Anderson Individual Corporate DirectorBoard of Directors Jan 1, 2021
Michael James Individual Operational/Managerial Control Jul 1, 1991
Adp of the SNF Jul 1, 1991
Meera Udayakumar Individual Corporate OfficerCmo Mar 6, 2023
Nicole M Kolacz Individual Corporate OfficerCno Apr 28, 2025
Melissa Anne Fitzpatrick Individual Corporate DirectorBoard of Directors Sep 1, 2020
Haylian Rene York Individual Operational/Managerial Control Jan 5, 2025
Adp of the SNF Jan 5, 2025
Ann S Collins Individual Corporate DirectorBoard of Directors May 1, 2016
Roy Conrad Tempke Individual Corporate OfficerVP Clinical Ops & Coo Holly Springs May 3, 2013
Marilyn R Pearson Individual Corporate DirectorBoard of Directors Mar 7, 2022
Benjamin J Mathew Individual Corporate OfficerChief Financial Officer Jan 8, 2023
Cristen Parker Page Individual Corporate DirectorBoard Member Mar 4, 2025
Ellen Caroll Individual Operational/Managerial Control Apr 29, 2016
Adp of the SNF Apr 29, 2016

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 43

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 43

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 3

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": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1376542878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076521",
            "telephone_number": "919-784-6600",
            "fax_number": "919-784-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076521",
            "telephone_number": "919-784-6600",
            "fax_number": "919-784-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-784-1440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "H0065",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "H0065",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "H0065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "AN4793114001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "33015",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "0093U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416062",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH PLAN OF NC",
            "identifier": "0093U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7152480",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AARP",
            "identifier": "XXXXXXXX9260",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MEDICARE COMPLETE",
            "identifier": "7152480",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "119744",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415369",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UNC REX Rehabilitation & Nursing Care Center of Raleigh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.