NPIMap

Organization Active NPI

Fayetteville Center for Nursing & Healing LLC

  • Skilled Nursing Facility
  • Fayetteville, GA
National Provider Identifier
1760061840
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FAYETTEVILLE CENTER FOR NURSING & HEALING LLC
Practice address
110 Brandywine Blvd
Fayetteville, GA 30214-1500
Phone
(770) 461-2928
NPI assigned
Apr 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Shlomo E Heller
Title
Ceo, Empire Care Centers
Phone
(470) 737-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

110 Brandywine Blvd
Fayetteville, GA 30214-1500

Mailing address

110 Brandywine Blvd
Fayetteville, GA 30214-1500
Phone (770) 461-2928

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210616002205 GA Part A Provider - Skilled Nursing Facility 7719387430 Practice locations: Fayetteville, GA

Skilled nursing facility certification: CCN 115360

Legal name
FAYETTEVILLE CENTER FOR NURSING & HEALING LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 20, 1989
Last certification
Feb 1, 2024
Beds
162
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Empire Care Centers LLC
Organization structure
LLCProprietary
Enrollment address
110 Brandywine Blvd
Fayetteville, GA 30214-1500
Nursing home name
FAYETTEVILLE CENTER FOR NURSING & HEALING LLC
Affiliated entity
EMPIRE CARE CENTERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fayetteville Center for Nursing & Healing LLCCCN 115360
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 20, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
162139.2 residents per day on average
Chain
Empire Care Centers20 facilities in the chain
Penalties (3 years)
2Fines totaling $11,171

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
11D2216883Fayetteville Center for Nursing & Healing110 Brandywine Boulevard, Fayetteville, GA 30214Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 29

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

NameRoleSinceShare
Rashunda Williams Individual Operational/Managerial Control Mar 18, 2024
Adp of the SNF Mar 18, 2024
Barry Donath Individual Operational/Managerial Control Jun 7, 2021
Managing Control - Governing BodyCfo Jun 7, 2021
Adp of the SNF Jun 7, 2021
Chrystal Stinson Individual Operational/Managerial Control Dec 29, 2024
Adp of the SNF Dec 29, 2024
Ensh Consulting LLC Organization, Brooklyn, NY LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2021 99%
Adp of the SNF May 1, 2021
Gladys Sone-Ebeloue Individual Operational/Managerial Control May 1, 2021
Adp of the SNF May 1, 2021
Organization, Portland, OR LLC, Consulting firm, For-profit Adp of the SNF Jun 30, 2025
Organization, Englewood Cliffs, NJ LLC, For-profit Adp of the SNF May 1, 2021
Carrie T Stephens Individual Operational/Managerial Control Jan 9, 2025
Adp of the SNF Jan 9, 2025
Kortney Simmons Johnson Individual Operational/Managerial Control Apr 6, 2025
Adp of the SNF Apr 6, 2025
Organization, Lakewood, NJ LLC, Holding company, For-profit Adp of the SNF May 1, 2021
Individual Adp of the SNF May 1, 2021
Jequeita Brown Individual Operational/Managerial Control Aug 14, 2023
Adp of the SNF Aug 14, 2023
Organization, Lakewood, NJ LLC, Holding company, For-profit Adp of the SNF May 1, 2021
Leanthony a Hardy Individual Operational/Managerial Control May 1, 2022
Adp of the SNF May 1, 2022
Individual Adp of the SNF Apr 1, 2024
Ga4 Opco Holding LLC Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2021 100%
Shannon Ferrall Individual Operational/Managerial Control May 20, 2024
Adp of the SNF May 20, 2024
Organization, Lakewood, NJ LLC, Holding company, For-profit Adp of the SNF May 1, 2021
Shlomo E Heller Individual 5% Or Greater Indirect Ownership Interest May 1, 2021 49.5%
Operational/Managerial Control May 1, 2021
Managing Control - Governing BodyCeo/LLC Manager May 1, 2021
Adp of the SNF May 1, 2021
Daeqwona Williams Individual Operational/Managerial Control May 5, 2025
Adp of the SNF May 5, 2025
Ephraim Nussbaum Individual 5% Or Greater Indirect Ownership Interest May 1, 2021
Operational/Managerial Control May 1, 2021
Managing Control - Governing BodyPresident May 1, 2021
Adp of the SNF May 1, 2021
Renee Ellis Individual Operational/Managerial Control May 1, 2021
Adp of the SNF May 1, 2021
Empire Care Centers LLC Organization, Brooklyn, NY LLC, Management services company, For-profit, Chain home office Operational/Managerial Control May 1, 2021
Adp of the SNF Jan 5, 2026
Stephanie Brown Individual Operational/Managerial Control Jun 20, 2022
Adp of the SNF Jun 20, 2022
Organization, Englewood Cliffs, NJ For-profit Adp of the SNF May 1, 2021
Aryeh L Swerdloff Individual Operational/Managerial Control May 1, 2021
Adp of the SNF May 1, 2021
Indirect Ownership Interest May 1, 2021 1%
Joel Reed Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Thomas McCain Individual Operational/Managerial Control Apr 4, 2025
Adp of the SNF Apr 4, 2025
Organization, Englewood Cliffs, NJ For-profit Adp of the SNF May 1, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 4

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": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1760061840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BRANDYWINE BLVD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141500",
            "telephone_number": "770-461-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BRANDYWINE BLVD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141500",
            "telephone_number": "770-461-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE CENTER FOR NURSING & HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO, EMPIRE CARE CENTERS",
        "authorized_official_telephone_number": "470-737-0111"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.