Active NPI
Greens at Gastonia LLC
- Skilled Nursing Facility
- Gastonia, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GREENS AT GASTONIA LLC
- Practice address
- 969 Cox Rd
Gastonia, NC 28054-3455 - Phone
- (704) 866-8596
- Fax
- (704) 866-8677
- NPI assigned
- May 27, 2022
- Last updated
- May 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob Stern
- Title
- Ceo
- Phone
- (513) 830-5342
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
969 Cox Rd
Gastonia, NC 28054-3455
Mailing address
15 America Ave Unit 304
Lakewood, NJ 08701-4582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220912002397 | NC | Part A Provider - Skilled Nursing Facility | 9830574854 | Practice locations: Gastonia, NC |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1851030985. Details of each certification follow.
Skilled nursing facility certification: CCN 345169
- Legal name
- GREENS AT GASTONIA LLC
- Doing business as
- THE GREENS AT GASTONIA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 1, 1977
- Last certification
- May 5, 2025
- Beds
- 162
- Ownership / control type
- Corporation
- Multi-facility organization
- CCH Healthcare
- Organization structure
- LLC
- Incorporated
- May 24, 2022 in NC
- Enrollment address
- 969 Cox Rd
Gastonia, NC 28054-3455 - Nursing home name
- THE GREENS AT GASTONIA
- Affiliated entity
- CCH HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Greens at Gastonia
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 1, 1977
- Medicare certification status
- Active
- Certified beds
- 162
- Chain
- CCH Healthcare
- Penalties (3 years)
- 3
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Shawnna Fairman | W-2 Managing Employee | Jul 1, 2022 | 100% |
| Capital Holdings Trust | 5% Or Greater Indirect Ownership Interest | Jul 1, 2022 | 47% |
| Baruch Jeremias | 5% Or Greater Indirect Ownership Interest | Jul 1, 2022 | 50% |
| Corporate Director | Jul 1, 2022 | 50% | |
| Bync Holdings LLC | 5% Or Greater Direct Ownership Interest | Jul 1, 2022 | 100% |
| Starlight Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Jul 1, 2022 | 50% |
| 10-26 Nationwide TR | 5% Or Greater Indirect Ownership Interest | Jul 1, 2022 | 50% |
| Jacob Stern | 5% Or Greater Indirect Ownership Interest | Jul 1, 2022 | 50% |
| Corporate Officer | Jul 1, 2022 | 100% | |
| Corporate Director | Jul 1, 2022 | 50% |
Facilities with the same owner 55
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Concord, NC
- NPI 1538808340
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Hendersonville, NC
- NPI 1013656156
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Hickory, NC
- NPI 1184363236
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Lincolnton, NC
- NPI 1518606664
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Statesville, NC
- NPI 1922747088
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust
-
- Skilled Nursing Facility
- Spruce Pine, NC
- NPI 1508505660
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Hickory, NC
- NPI 1255070306
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
- Skilled Nursing Facility
- Weaverville, NC
- NPI 1417696576
10-26 Nationwide TR, Bync Holdings LLC, Capital Holdings Trust, Starlight Healthcare LLC
-
dba The Greens At Pinehurst Rehabilitation & Living Center
- Skilled Nursing Facility
- Pinehurst, NC
- NPI 1528544145
Starlight Healthcare LLC
-
dba Pineville Rehabilitation and Living Center
- Skilled Nursing Facility
- Pineville, NC
- NPI 1922456664
10-26 Nationwide TR, Capital Holdings Trust, Starlight Healthcare LLC
-
dba Ridgewood Living and Rehabilitation Center
- Skilled Nursing Facility
- Washington, NC
- NPI 1306293170
10-26 Nationwide TR, Starlight Healthcare LLC
-
dba Valley Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Taylorsville, NC
- NPI 1285403899
10-26 Nationwide TR, Capital Holdings Trust, Starlight Healthcare LLC
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Medicine & Rehabilitation Physician
- Charlotte, NC
- NPI 1811027162
-
- Internal Medicine Physician
- Gastonia, NC
- NPI 1346228012
-
- Family Medicine Physician
- Salisbury, NC
- NPI 1730162777
Affiliated clinicians 2
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": "1653609600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653609600000",
"number": "1851030985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 AMERICA AVE UNIT 304",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "969 COX RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280543455",
"telephone_number": "704-866-8596",
"fax_number": "704-866-8677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREENS AT GASTONIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-27",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A",
"authorized_official_last_name": "STERN",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "513-830-5342"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.