Liberty Healthcare Group LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0515 Issued in NC

Legal business name

LIBERTY HEALTHCARE GROUP LLC

Doing business as

Cross Creek Health Care

Practice address

1719 Quarter Road
Swan Quarter, NC 27885

Phone

(252) 926-2143

Fax

(252) 926-2414

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joe Calcutt

Title

Cfo

Phone

(910) 332-1793

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Cross Creek Health Care Doing business as

Member of 1

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

• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Matthews, NC
  • NPI 1336193754

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1437103850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 SOUTH 41ST STREET",
            "address_2": "LIBERTY HEALTHCARE MANAGEMENT INC",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-332-1777",
            "fax_number": "910-815-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 QUARTER ROAD",
            "city": "SWAN QUARTER",
            "state": "NC",
            "postal_code": "27885",
            "telephone_number": "252-926-2143",
            "fax_number": "252-926-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "CALCUTT",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-332-1793",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3435407",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343600E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Creek Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cross Creek Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol B Cox
• Jacqueline I. Hutcherson, NP
• Hyde County DSS
• Hyde County DSS
• Hyde County Non-Profit Private Transportation Corporation
• Tideland Mental Health Center- Swan Quarter Office
• Angela Williams-Crets, RD
• Emma Cahoon Williams, FNP

• Skilled Nursing Facility in Swan Quarter, NC
• Providers in Swan Quarter, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.