Randolph Gardens SNF Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RANDOLPH GARDENS SNF OPERATIONS LLC

Practice address

4801 Randolph Rd
Charlotte, NC 28211-2921

Phone

(704) 364-8363

NPI assigned

Oct 10, 2024

Organization subpart

No

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

Authorized official

Name

Joseph Lieberman

Title

Vice President of Procurement

Phone

(646) 275-4510

Specialties & licenses 1

Addresses

Other names 1

• Sherwood Health & Rehab Doing business as

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1932929403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112921",
            "telephone_number": "704-364-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH GARDENS SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PROCUREMENT",
        "authorized_official_telephone_number": "646-275-4510"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sherwood Health & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Randle
• Morgan Randleman
• Shaunda Rae Randleman, LCMHC
• Randolph Chiropractic Health Center PA
• Randolph Gardens Opco LLC
• Randolph Internal Medicine Associates
• Randolph L. Kixmiller,DDS,PA
• Nasir I Randolph-Powell, MSW, LCSWA
• Ashton Randolph
• Crystal Randolph, CCC-SLP

• All providers in Charlotte, NC
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.