Carolina Bay Healthcare Center of Wilmington, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CAROLINA BAY HEALTHCARE CENTER OF WILMINGTON, LLC

Practice address

740 Diamond Shoals Rd
Wilmington, NC 28403-4388

Phone

(910) 769-7500

Fax

(910) 769-7573

NPI assigned

Sep 26, 2018

Organization subpart

No

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

Authorized official

Name

Jeffrey Wilson

Title

Coo

Phone

(910) 815-3122

Specialties & licenses 1

Addresses

Other names 1

• Bradley Creek Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Skilled nursing facility certification: CCN 345571

Legal name

CAROLINA BAY HEALTHCARE CENTER OF WILMINGTON, LLC

Doing business as

BRADLEY CREEK HEALTH CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Aug 18, 2016

Last certification

Apr 11, 2024

Beds

108 (30 certified)

Ownership / control type

Corporation

Multi-facility organization

Liberty Senior Living

Organization structure

LLCProprietary

Incorporated

Aug 10, 2018 in DE

Enrollment address

740 Diamond Shoals Rd
Wilmington, NC 28403-4388

Listed as

Bradley Creek Health CenterCCN 345571

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare

Ownership

For profit - Corporation

Certified

Aug 18, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3029.8 residents per day on average

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

Locations

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.

Affiliated clinicians 1

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

• Mary Kathryn Rudyk, M.D.

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1023165289

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1821573809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 41ST ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 DIAMOND SHOALS RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034388",
            "telephone_number": "910-769-7500",
            "fax_number": "910-769-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA BAY HEALTHCARE CENTER OF WILMINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "910-815-3122"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradley Creek Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Spencer Carney, M.D.
• Jasmine Carney
• Susan Fowler Carney, CNM
• Carolina Active Care Chiropractic
• Carolina Arthritis Associates, P.a.
• Carolina Care - Urgent Care and Sports Medicine
• Carolina Case Management, Inc
• Carolina Coast Speech Therapy, PLLC
• Carolina Dermatology and Skin Cancer Surgery PA
• Carolina Diagnostics Inc

• Skilled Nursing Facility in Wilmington, NC
• Providers in Wilmington, 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 Mar 5, 2020; 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.