NPIMap

Organization Active NPI

Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Charlotte, NC
National Provider Identifier
1487797817
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0063 Issued in NC
Legal business name
LIBERTY HEALTHCARE GROUP LLC
Practice address
3700 Shamrock Dr
Charlotte, NC 28215-3218
Phone
(704) 940-8300
Fax
(704) 940-8369
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joe Calcutt
Title
Cfo
Phone
(910) 332-1793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0063 NC Primary

Addresses

Primary practice location

3700 Shamrock Dr
Charlotte, NC 28215-3218

Mailing address

2334 S 41St St
Liberty Healthcare Managment Inc
Wilmington, NC 28403-5502
Phone (910) 815-3122

Other identifiers 1

IdentifierTypeStateIssuer
3426113MedicaidNC

Other names 1

  • Liberty Nursing and Rehab Center of Mecklenburg Co Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Liberty Healthcare Group LLC119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3700 Shamrock Dr
Charlotte, NC 28215
Phone (704) 384-8300

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487797817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 S 41ST ST",
            "address_2": "LIBERTY HEALTHCARE MANAGMENT INC",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122",
            "fax_number": "910-642-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SHAMROCK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153218",
            "telephone_number": "704-940-8300",
            "fax_number": "704-940-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3426113",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Nursing and Rehab Center of Mecklenburg Co",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.