Organization Active NPI

The Cardinal at North Hills Healthcare, LLC

  • Assisted Living Facility
  • Raleigh, NC
National Provider Identifier
1407227382
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
THE CARDINAL AT NORTH HILLS HEALTHCARE, LLC
Practice address
311 Garden at North Hills
Raleigh, NC 27609
Phone
(760) 804-5900
NPI assigned
Oct 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Terri Novak
Title
Vice President
Phone
(760) 804-5900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Alzheimer Center (Dementia Center) 311500000X
Skilled Nursing Facility 314000000X

Addresses

Primary practice location

311 Garden at North Hills
Raleigh, NC 27609

Mailing address

5790 Fleet St
Suite 300
Carlsbad, CA 92008-4703
Phone (760) 804-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161215000184 NC Part A Provider - Skilled Nursing Facility 0547540296 Practice locations: Raleigh, NC

Skilled nursing facility certification: CCN 345572

Legal name
THE CARDINAL AT NORTH HILLS HEALTHCARE, LLC
Doing business as
THE CARDINAL AT NORTH HILLS
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jun 28, 2017
Last certification
Sep 19, 2024
Beds
15
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Kisco Senior Living
Organization structure
LLCProprietary
Incorporated
Feb 12, 2008 in NC
Enrollment address
311 Garden at North Hills
Raleigh, NC 27609
Nursing home name
THE CARDINAL AT NORTH HILLS
Affiliated entity
KISCO SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Cardinal at North HillsCCN 345572
Overall star rating
3 of 5
Health inspections
4 of 5
Quality measures
1 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Jun 28, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
159.5 residents per day on average
Chain
Kisco Senior Living2 facilities in the chain
Penalties (3 years)
1Fines totaling $7,901

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
34D2126487Cardinal at North Hills Healthcare, LLC311 Garden at North Hills Street, Raleigh, NC 27609Certificate of waiverFeb 27, 2027

National Provider Directory

National Provider Directory

Locations

5790 Fleet St
Ste 300
Carlsbad, CA 92008

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Scott Kohlberg Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013
Breck Austin Individual Corporate OfficerOperations Services Project Manager Jan 1, 2013
W-2 Managing EmployeeOperations Services Project Manager Jan 1, 2013
Mitchell Ritschel Individual Corporate OfficerChief Investment Officer Dec 1, 2012
Jaime Pacheco Individual W-2 Managing EmployeeNursing Home Administrator Nov 24, 2022 100%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1407227382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5790 FLEET ST",
            "address_2": "SUITE 300",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084703",
            "telephone_number": "760-804-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 GARDEN AT NORTH HILLS",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "760-804-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CARDINAL AT NORTH HILLS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "760-804-5900"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.