NPIMap

Organization Active NPI

Commonwealth of Kentucky

Doing business as Carl M.Brashear Radcliff Veterans Center

  • Skilled Nursing Facility
  • Radcliff, KY
National Provider Identifier
1043686900
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMMONWEALTH OF KENTUCKY
Doing business as
Carl M.Brashear Radcliff Veterans Center
Practice address
100 Veterans Dr
Radcliff, KY 40160-9515
Phone
(270) 352-6700
Fax
(270) 351-5530
NPI assigned
Aug 14, 2015
Last updated
Nov 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Amy Corrine Miller
Title
Fiscal Manager
Phone
(270) 352-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

100 Veterans Dr
Radcliff, KY 40160-9515

Mailing address

100 Veterans Drive
Radcliff, KY 40160

Other identifiers 2

IdentifierTypeStateIssuer
1043686900OtherKYNPI
7100477940MedicaidKY

Other names 1

  • Carl M.Brashear Radcliff Veterans Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160425002573 KY Part A Provider - Skilled Nursing Facility 0840180816 Practice locations: Radcliff, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043686900. Details of each certification follow.

Skilled nursing facility certification: CCN 185483

Legal name
COMMONWEALTH OF KENTUCKY
Doing business as
CARL M BRASHEAR RADCLIFF VETERANS CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 25, 2017
Last certification
Mar 6, 2025
Beds
120
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
100 Veterans Dr
Radcliff, KY 40160-9515
Nursing home name
RADCLIFF VETERANS CENTER

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
Radcliff Veterans CenterCCN 185483 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
May 25, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12056.5 residents per day on average
Penalties (3 years)
1Fines totaling $9,331

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2120671Carl M Brashear Radcliff Veterans Center100 Veterans Drive, Radcliff, KY 40160Certificate of waiverOct 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of Kentucky126 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

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

  • Commonwealth of Kentucky

    dba Eastern State Hospital Long Term Care/Acquired Brain Injury (LTC/ABI)

    • Skilled Nursing Facility
    • Lexington, KY
    • NPI 1356764559

    Member Of

    NPD member

Locations

1800 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-2301

100 Veterans Dr
Radcliff, KY 40160
Phone (270) 352-6700

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lanetta S Popplewell Individual Operational/Managerial Control Feb 22, 2016
Adp of the SNF Feb 22, 2016
Joy Greer Scott Individual Operational/Managerial Control Nov 1, 2016
Adp of the SNF Nov 1, 2016
Mark Bowman Individual Operational/Managerial Control May 9, 2016
Adp of the SNF May 9, 2016
Amy Miller Individual Operational/Managerial Control Apr 1, 2022
Commonwealth of Kentucky Organization, Radcliff, KY Non-profit 5% Or Greater Direct Ownership Interest Apr 16, 2017 100%

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 1

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

FacilityTypeRoleSince
Central State HospitalLouisville, KY, CCN 184015 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 1992

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 4

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

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1043686900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VETERANS DRIVE",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "40160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VETERANS DR",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401609515",
            "telephone_number": "270-352-6700",
            "fax_number": "270-351-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF KENTUCKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "CORRINE",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "270-352-6700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043686900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100477940",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carl M.Brashear Radcliff Veterans Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Radcliff, KY

Sources for this page

Verify at the official NPI Registry.