NPIMap

Organization Active NPI

The United Methodist Retirement Homes, Incorporated

Doing business as Croasdaile Village

  • Skilled Nursing Facility
  • Durham, NC
National Provider Identifier
1972587376
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0587 Issued in NC
Legal business name
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Doing business as
Croasdaile Village
Practice address
2600 Croasdaile Farm Pkwy
Durham, NC 27705-1331
Phone
(919) 384-2000
Fax
(919) 384-2480
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Authorized official

Name
Mr. Jonathan P Erickson
Title
Assistant Secretary
Phone
(919) 384-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0587 NC Primary

Addresses

Primary practice location

2600 Croasdaile Farm Pkwy
Durham, NC 27705-1331

Mailing address

2600 Croasdaile Farm Parkway
Durham, NC 27705-1331
Phone (919) 384-2000

Other identifiers 3

IdentifierTypeStateIssuer
3405501MedicaidNC
340612YMedicaidNC
00880OtherNCBCBS

Other names 1

  • Croasdaile Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030317000025 NC Part A Provider - Skilled Nursing Facility 1850200098 Practice locations: Durham, NC

Skilled nursing facility certification: CCN 345501

Legal name
THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED
Doing business as
CROASDAILE VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 3, 2000
Last certification
Jul 11, 2024
Beds
110 (102 certified)
Ownership / control type
Nonprofit Corporation
Multi-facility organization
United Methodist Retirement Home Inc
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1946 in NC
Enrollment address
2600 Croasdaile Farm Pkwy
Ofc
Durham, NC 27705-1331
Nursing home name
CROASDAILE VILLAGE
Affiliated entity
LIFE CARE SERVICES

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Croasdaile VillageCCN 345501 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 3, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10281.5 residents per day on average
Chain
Life Care Services43 facilities in the chain
Penalties (3 years)
2Fines totaling $25,275

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Wesley Pines Meth Ret H5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Gaynelle Patterson Individual Corporate DirectorBoard Trustee Jan 1, 2026
Stacy Dobson Individual Corporate OfficerChief Financial Officer Jul 10, 2006
Sheryl B Taylor Individual Corporate DirectorBoard Trustee Feb 23, 2023
John Davison Individual Corporate DirectorBoard Trustee Jan 1, 2026
Neema Kapadia Sharda Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Apr 21, 2025
The United Methodist Retirement Homes, Incorporated Organization, Durham, NC Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 13, 2011 100%
Nancy R Little Individual Corporate DirectorBoard Trustee Aug 22, 2024
Kenneth K Steinweg Individual Corporate DirectorBoard Trustee Nov 4, 2021
Woo Il Lee Individual Corporate DirectorBoard Trustee Dec 31, 2018
Rebecca Elizabeth Marion Individual Operational/Managerial Control Mar 17, 2001
Life Care Services LLC Organization, Des Moines, IA LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2000
Adp of the SNF Apr 16, 2025
Sanya Rizwan Alam Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Apr 21, 2025
William Harriss Individual Corporate OfficerChair Nov 3, 2022
Corporate DirectorBoard Trustee Nov 7, 2019
Nancy J. Van Antwerp Individual Corporate OfficerTreasurer Oct 30, 2025
Corporate DirectorBoard Trustee Nov 7, 2019
Jonathan Erickson Individual Corporate OfficerRecording Secretary Nov 1, 2006
Corporate DirectorCorporate Executive Director Nov 1, 2006
James E Martin Individual Corporate DirectorBoard Trustee Feb 23, 2023
Harvey G Southern Individual Corporate OfficerSecretary Oct 30, 2025
Corporate DirectorBoard Trustee Oct 29, 2020
Mack B Parker Individual Corporate OfficerVice-Chair Oct 30, 2025
Corporate DirectorBoard Trustee Nov 3, 2022
Heather Dawn March Individual Operational/Managerial Control Oct 1, 2001
US Bank National Association Organization, Raleigh, NC Corporation, Financial institution, For-profit 5% Or Greater Security Interest Sep 1, 2014
Spence Evans Individual Corporate DirectorBoard Trustee Jan 1, 2026

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wesley Pines Retirement CommunityLumberton, NC, CCN 345180 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 13, 2011
Cypress Glen Retirement CommunityGreenville, NC, CCN 345512 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 57

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

View all 57

Practitioners & affiliated clinicians

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": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1972587376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CROASDAILE FARM PARKWAY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277051331",
            "telephone_number": "919-384-2000",
            "fax_number": "919-384-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CROASDAILE FARM PKWY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277051331",
            "telephone_number": "919-384-2000",
            "fax_number": "919-384-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNITED METHODIST RETIREMENT HOMES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "919-384-3001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405501",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340612Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00880",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Croasdaile Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.