LIBERTY COMMONS NURSING & REHABILITATION CENTER OF SOUTHPORT, LLC
NPI 1548770423
Skilled Nursing Facility in Southport, NC

Active since October 05, 2017CLIA 34D0674158 · Waiver
630 N FODALE AVE, SOUTHPORT, NC 28461(910) 457-9581 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 11, 2022, Jun 20, 2019, Jun 5, 2019 and 1 more (4 updates tracked since 2018).

About Liberty Commons Nursing & Rehabilitation Center Of Southport, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIBERTY COMMONS NURSING & REHABILITATION CENTER OF SOUTHPORT, LLC (NPI 1548770423) is a healthcare organization registered as a skilled nursing facility in Southport, North Carolina and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Joseph V Calcutt, Cfo, as its authorized official.

NPPES Registry Identity

NPI1548770423
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLIBERTY HEALTHCARE GROUP LLC
Location Address630 N FODALE AVESouthport, NC 28461
Mailing Address44 Mcneill PlzWhiteville, NC 28472-8602 · (910) 642-0224
Organization SubpartNo
Authorized OfficialJoseph V CalcuttCfo · (910) 815-3122
Enumeration DateOctober 5, 2017
Last NPPES UpdateAugust 11, 20224 updates tracked since enumeration
NPPES CertifiedAugust 11, 2022
NPI 1548770423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedAssisted Living FacilityTaxonomy 310400000X
630 N FODALE AVE, Southport, NC 28461

Other Names 1

Doing Business AsLiberty Commons Nursing & Rehabilitation Center Of Southport, Llc

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0674158

Liberty Commons Nursing & Rehabilitation Of Southport, LLC · Southport, NC
Active · expires Aug 31, 2026
CLIA Number34D0674158
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJames Nicola
Laboratory Phone(910) 457-9581
Laboratory LocationLiberty Commons Nursing & Rehabilitation Of Southport, LLC630 N Fodale Avenue, Southport, NC 28461
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
630 N FODALE AVE
SOUTHPORT, NC 28461
Occupational Therapist
630 N FODALE AVE
SOUTHPORT, NC 28461
Occupational Therapy Assistant
630 N FODALE AVE
SOUTHPORT, NC 28461
Occupational Therapist
630 N FODALE AVE
SOUTHPORT, NC 28461
Speech-Language Pathologist
630 N FODALE AVE
SOUTHPORT, NC 28461
Occupational Therapist
630 N FODALE AVE
SOUTHPORT, NC 28461
Physical Therapy Assistant
630 N FODALE AVE
SOUTHPORT, NC 28461
Physical Therapist
630 N FODALE AVE
SOUTHPORT, NC 28461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Liberty Healthcare Group LLC's NPI number?

The NPI number for Liberty Healthcare Group LLC is 1548770423. It was assigned to this organization in the NPPES registry on October 5, 2017. The provider is doing business as Liberty Commons Nursing & Rehabilitation Center Of Southport, LLC.

Where is Liberty Healthcare Group LLC located?

Liberty Healthcare Group LLC is located at 630 N Fodale Ave, Southport, NC 28461. The listed phone number is (910) 457-9581.

What is Liberty Healthcare Group LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Liberty Healthcare Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0674158) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Liberty Healthcare Group LLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and UnitedHealthcare list Liberty Healthcare Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Liberty Healthcare Group LLC was last updated on August 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.