NPIMap

Organization Active NPI

West Liberty Care Center, Inc.

Doing business as Otterbein Green Hills

  • Skilled Nursing Facility
  • West Liberty, OH
National Provider Identifier
1023824679
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WEST LIBERTY CARE CENTER, INC.
Doing business as
Otterbein Green Hills
Practice address
6557 US Highway 68 S
West Liberty, OH 43357-9536
Phone
(937) 465-5065
NPI assigned
Dec 9, 2024
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Michael S Ray
Title
Ceo
Phone
(937) 650-7103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6557 US Highway 68 S
West Liberty, OH 43357-9536

Mailing address

6557 US Highway 68 S
West Liberty, OH 43357-9536
Phone (937) 465-5065

Other names 1

  • Otterbein Green Hills Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310000375 OH Part A Provider - Skilled Nursing Facility 1850573916 1 other NPI on this enrollment
Practice locations: West Liberty, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023824679. Details of each certification follow.

Skilled nursing facility certification: CCN 365362

Legal name
WEST LIBERTY CARE CENTER INC
Doing business as
OTTERBEIN GREEN HILLS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 13, 1977
Last certification
Jul 13, 2023
Beds
74
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 1972 in OH
Enrollment address
6557 US Highway 68 S
West Liberty, OH 43357-9536
Nursing home name
GREEN HILLS CENTER
Affiliated entity
OTTERBEIN SENIORLIFE

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Green Hills CenterCCN 365362 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Oct 13, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7472.6 residents per day on average
Chain
Otterbein Seniorlife20 facilities in the chain
Penalties (3 years)
1Fines totaling $16,801

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
West Liberty Care Center Inc5 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Richard Gildow Individual Corporate DirectorDirector Dec 23, 2024
Steven Jay Godwin Individual Corporate DirectorDirector Dec 23, 2024
Barbara Haushalter Individual Corporate DirectorDirector Dec 23, 2024
Valerie Jean Jones Individual Corporate DirectorDirector Dec 23, 2024
Jason E Miller Individual Corporate OfficerSenior Vice President Dec 23, 2024
John Bodin Individual Corporate DirectorDirector Jan 26, 2012
Amanda Goble Individual Corporate DirectorDirector Dec 23, 2024
Otterbein LSC, LLC Organization, Lebanon, OH LLC, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 23, 2024 100%
Adp of the SNF Dec 23, 2024
Charles Vernon Kratz Individual Operational/Managerial Control Dec 23, 2024
Adp of the SNF Dec 23, 2024
Jill Wilson Individual Corporate OfficerPresident and Ceo Dec 23, 2024
Thomas Simon Individual Corporate DirectorDirector Jan 1, 2017
Nicole C Daniels Individual Operational/Managerial Control Jul 1, 2025
Tony Burtchin Individual Corporate DirectorDirector Dec 23, 2024
Otterbein Home Organization, Lebanon, OH Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2023 100%
Adp of the SNF Dec 23, 2024
James Christopher Green Individual Corporate OfficerTreasurer and Ceo Dec 23, 2024
Alexander Richard Dye Individual Corporate DirectorDirector Dec 23, 2024
Amber Swords Individual Corporate Director Oct 22, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1023824679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6557 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579536",
            "telephone_number": "937-465-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6557 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579536",
            "telephone_number": "937-465-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LIBERTY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-650-7103"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otterbein Green Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Liberty, OH

Sources for this page

Verify at the official NPI Registry.