King Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

KING OPERATOR LLC

Doing business as

King Health and Rehabilitation Center

Practice address

115 White Rd
King, NC 27021-9526

Phone

(336) 983-6505

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Craig Neiswanger

Title

Authorized Agent

Phone

(336) 983-6505

Specialties & licenses 1

Addresses

Other names 1

• King Health and Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Skilled nursing facility certification: CCN 345449

Legal name

KING OPERATOR LLC

Doing business as

KING HEALTH AND REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 11, 1993

Last certification

Apr 16, 2025

Beds

120 (96 certified)

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Medical Facilities of America

Most recent change of ownership

Jun 1, 2024

Organization structure

LLC

Enrollment address

115 White Road
King, NC 27021-9526

Nursing home name

KING HEALTH AND REHABILITATION CENTER

Affiliated entity

LIFEWORKS REHAB

Listed as

King Health and Rehabilitation CenterCCN 345449 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Nov 11, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9690.7 residents per day on average

Chain

Lifeworks Rehab64 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 36

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 3

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

• Julius Chamberlain Shayo, NP-C

  • Primary Care Nurse Practitioner
  • Holly Springs, NC
  • NPI 1750927018

  Managing Control - Governing Body

  CMS ownership
• Jonathan Kenton Tackett, M.D.

  • Family Medicine Physician
  • Chapel Hill, NC
  • NPI 1407203888

  Adp of the SNF

  CMS ownership
• Jill Elaine Van Horn, DO

  • Family Medicine Physician
  • Yanceyville, NC
  • NPI 1669584835

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

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

• Javier Cruz, MD

  • General Practice Physician
  • Winston Salem, NC
  • NPI 1952095267

  Nursing home

  Care Compare affiliation
• Surah Grumet, MD

  • Family Medicine Physician
  • Durham, NC
  • NPI 1497885354

  Nursing home

  Care Compare affiliation
• Jill Elaine Van Horn, DO

  • Family Medicine Physician
  • Yanceyville, NC
  • NPI 1669584835

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1790536951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WHITE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270219526",
            "telephone_number": "336-983-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WHITE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270219526",
            "telephone_number": "336-983-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "NEISWANGER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "336-983-6505"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy M Kilpatrick, MD
• King Dialysis Center of Wake Forest University (King Dialysis Center)
• King Drug Co., LLC (King Drug Co)
• King Medical Associates
• King Medical Transport, Inc.
• Benjamin Ross Kiser, PHARMD
• Megan Kistler
• Kulits Eyecare & Surgery PLLC
• Ashlee Perkinson Laughey, MD
• Lifebrite Hospital Group of Stokes, LLC (LifeBrite Family Medical And Specialty of King)

• Skilled Nursing Facility in King, NC
• Providers in King, 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 Jul 10, 2024; 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.