Liberty Healthcare Group LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0606 Issued in NC

Legal business name

LIBERTY HEALTHCARE GROUP LLC

Practice address

2315 Hwy 242 North
Benson, NC 27504

Phone

(919) 207-1717

Fax

(919) 207-1529

NPI assigned

May 19, 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 3

Other names 1

• Liberty Commons Nursing and Rehabilitation Center of Johnston County Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Skilled nursing facility certification: CCN 345519

Legal name

LIBERTY HEALTHCARE GROUP LLC

Doing business as

LIBERTY COMMONS NURSING AND REHABILITATION CENTER OF JOHNSTON COUNTY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 25, 2002

Last certification

Jul 12, 2024

Beds

100

Ownership / control type

Corporation

Multi-facility organization

Liberty Health Care

Organization structure

LLCProprietary

Enrollment address

2315 Hwy 242 N
Benson, NC 27504-7820

Nursing home name

LIBERTY COMMONS NURSING & REHABILITATION CENTER OF JOHNSTON COUNTY

Affiliated entity

LIBERTY SENIOR LIVING

Listed as

Liberty Commons Nursing & Rehabilitation Center ofCCN 345519

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Sep 25, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10094.6 residents per day on average

Chain

Liberty Senior Living37 facilities in the chain

Penalties (3 years)

2Fines totaling $15,593

Processed by Care Compare on Aug 1, 2026.

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.

• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Southport, NC
  • NPI 1548770423
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1598808065
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Burlington, NC
  • NPI 1629111364
  NPD tax ID
• Liberty Healthcare Group LLC

  • Community Based Hospice Care Agency
  • Supply, NC
  • NPI 1629156872
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Salisbury, NC
  • NPI 1710021779
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Clinton, NC
  • NPI 1720033475
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1730817776
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Skilled Nursing Facility
  • Pinehurst, NC
  • NPI 1548696834
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Assisted Living Facility
  • Louisburg, NC
  • NPI 1578118089
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Skilled Nursing Facility
  • Elizabethtown, NC
  • NPI 1588219828
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Case Management Agency
  • Wilmington, NC
  • NPI 1629217856
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Skilled Nursing Facility
  • Blowing Rock, NC
  • NPI 1629535455
  NPD tax ID

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 1

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

• Michael James, M.D.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1538161609

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 28

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facilities with the same owner 20

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

• Liberty Commons Nursing and Rehabilitation Center of Highland

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1811611577

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Commons of Robeson County

  • Skilled Nursing Facility
  • Lumberton, NC
  • NPI 1053090092

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Clinton, NC
  • NPI 1043263981

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Assisted Living Facility
  • Weldon, NC
  • NPI 1164476636

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Raleigh, NC
  • NPI 1255385720

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Burlington, NC
  • NPI 1326089616

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Matthews, NC
  • NPI 1336193754

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Salisburg, NC
  • NPI 1407800972

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Clinton, NC
  • NPI 1720033475

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1861446338

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Windsor, NC
  • NPI 1881648350

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1891740544

  Liberty Long Term Care LLC

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael James, M.D.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1538161609
  NPD (past)
• John Francis Lue Jr., M.D.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1508868688
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael James, M.D.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1538161609

  Nursing home

  Care Compare affiliation
• John Francis Lue Jr., M.D.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1508868688

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1669425401",
    "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": "910-642-0224",
            "fax_number": "910-815-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 HWY 242 NORTH",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "27504",
            "telephone_number": "919-207-1717",
            "fax_number": "919-207-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "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": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415519",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341613Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "009CU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Commons Nursing and Rehabilitation Center of Johnston County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liberty Commons Nursing and Rehabilitation Center of Johnston County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larry a. Williams, DDS, PA
• Dongmin Lee, D.D.S.
• Martin Davis Lee, D.C.
• Liberty Healthcare Group LLC
• Liberty Healthcare Group LLC
• Christina Lo, PHARMD
• Ashley Y Luckett, FNP-C
• Jodie Ann Lumbrazo, RPH
• Michael Lumbrazo, DC
• Stephanie Luna, PA

• All providers in Benson, NC
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.