NPIMap

Organization Active NPI

The United Methodist Retirement Homes, Incorporated

  • Skilled Nursing Facility
  • Greenville, NC
National Provider Identifier
1720412331
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0473 Issued in NC
Legal business name
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Practice address
100 Hickory St
Greenville, NC 27858
Phone
(252) 830-0036
Fax
(252) 830-0411
NPI assigned
Aug 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Mr. Jonathan Erickson
Title
Assistant Secretary/Corp Exec Dir
Phone
(919) 384-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0473 NC Primary

Addresses

Primary practice location

100 Hickory St
Greenville, NC 27858

Mailing address

100 Hickory St
Greenville, NC 27858-1637
Phone (252) 830-0036

Other identifiers 1

IdentifierTypeStateIssuer
009CHOtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • Cypress Glen Retirement Community Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130924000862 NC Part A Provider - Skilled Nursing Facility 1850200098 Practice locations: Greenville, NC

Skilled nursing facility certification: CCN 345512

Legal name
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Doing business as
CYPRESS GLEN RETIREMENT COMMUNITY
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 10, 2002
Last certification
Sep 19, 2024
Beds
6
Ownership / control type
Nonprofit Corporation
Multi-facility organization
The United Methodist Retirement Homes
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1946 in NC
Enrollment address
100 Hickory St
Greenville, NC 27858-1637
Nursing home name
CYPRESS GLEN RETIREMENT COMMUNITY
Affiliated entity
LIFE CARE SERVICES

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cypress Glen Retirement CommunityCCN 345512
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 10, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
63.4 residents per day on average
Chain
Life Care Services43 facilities in the chain

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
34D1105798United Methodist Retirement Homes Inc, the100 Hickory Street, Greenville, NC 27858Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wesley Pines Meth Ret H5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Laurie Stallings Individual Operational/Managerial Control Jan 24, 1994
Gaynelle Patterson Individual Corporate DirectorBoard Trustee Jan 1, 2026
Stacy Dobson Individual Corporate OfficerChief Financial Officer Jul 10, 2006
Sheryl B Taylor Individual Corporate DirectorBoard Trustee Feb 23, 2023
John Davison Individual Corporate DirectorBoard Trustee Jan 1, 2026
The United Methodist Retirement Homes, Incorporated Organization, Durham, NC Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2013 100%
Nancy R Little Individual Corporate DirectorBoard Trustee Feb 23, 2023
Kenneth K Steinweg Individual Corporate DirectorBoard Trustee Nov 4, 2021
Woo Il Lee Individual Corporate DirectorBoard Trustee Dec 31, 2018
Terry E Hayes Individual Operational/Managerial Control Dec 17, 2022
Adp of the SNF Jan 2, 2026
Life Care Services LLC Organization, Des Moines, IA LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2000
Adp of the SNF Apr 16, 2025
William Harriss Individual Corporate OfficerChair Nov 3, 2022
Corporate DirectorBoard Trustee Nov 7, 2019
Nancy J. Van Antwerp Individual Corporate OfficerTreasurer Oct 30, 2025
Corporate DirectorBoard Trustee Nov 7, 2019
Jonathan Erickson Individual Corporate OfficerRecording Secretary Nov 1, 2006
Corporate DirectorCorporate Executive Director Nov 1, 2006
James E Martin Individual Corporate DirectorBoard Trustee Feb 23, 2023
Harvey G Southern Individual Corporate OfficerSecretary Oct 30, 2025
Corporate DirectorBoard Trustee Oct 29, 2020
Mack B Parker Individual Corporate OfficerVice-Chair Oct 30, 2025
Corporate DirectorBoard Trustee Nov 3, 2022
Gerardo Gonzalez Rodriguez Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Mar 26, 2025
US Bank National Association Organization, Raleigh, NC Corporation, Financial institution, For-profit 5% Or Greater Security Interest Sep 1, 2014
Spence Evans Individual Corporate DirectorBoard Trustee Jan 1, 2026

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Croasdaile VillageDurham, NC, CCN 345501 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 13, 2011
Wesley Pines Retirement CommunityLumberton, NC, CCN 345180 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 13, 2011

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 57

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

View all 57

Practitioners & affiliated clinicians

Practitioners 9

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

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": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1720412331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HICKORY ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278581637",
            "telephone_number": "252-830-0036",
            "fax_number": "252-830-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HICKORY ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-830-0036",
            "fax_number": "252-830-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY/CORP EXEC DIR",
        "authorized_official_telephone_number": "919-384-3001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "009CH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cypress Glen Retirement Community",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cypress Glen Retirement Community",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.