NPIMap

Organization Active NPI

Uhs of Benton, LLC

Doing business as Rivendell Behavioral Health Services of Arkansas

  • Psychiatric Hospital
  • Benton, AR
National Provider Identifier
1063482735
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
AR4219 Issued in AR
Legal business name
UHS OF BENTON, LLC
Doing business as
Rivendell Behavioral Health Services of Arkansas
Practice address
100 Rivendell Dr
Benton, AR 72015-9188
Phone
(501) 316-1255
NPI assigned
Jan 25, 2006
Last updated
Aug 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Authorized official

Name
Steve Filton
Title
Sr VP Cfo
Phone
(610) 768-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X AR4219 AR Primary

Addresses

Primary practice location

100 Rivendell Dr
Benton, AR 72015-9188

Mailing address

100 Rivendell Dr
Benton, AR 72015-9188
Phone (501) 316-1255

Other identifiers 1

IdentifierTypeStateIssuer
154265125MedicaidAR

Other names 1

  • Rivendell Behavioral Health Services of Arkansas Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040517000657 AR Part A Provider - Hospital 3173513504 Practice locations: Benton, AR
O20070726000853 AR Part B Supplier - Clinic/Group Practice 3173513504 Receives reassigned benefits from 4 practitioners
Practice locations: Benton, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063482735. Details of each certification follow.

Hospital certification: CCN 044007

Legal name
UHS OF BENTON LLC
Doing business as
RIVENDELL BEHAVIORAL HEALTH SERVICES OF ARKANSAS
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Sep 4, 1985
Last certification
Apr 12, 2024
Beds
80
Ownership / control type
Private (for profit)
Most recent change of ownership
May 1, 2004 (3 total)
Organization structure
LLCProprietary
Incorporated
Mar 25, 2004 in DE
Enrollment address
100 Rivendell Drive
Benton, AR 72015-9188
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Rivendell Behavioral Health ServicesCCN 044007 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

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
04D0049600Rivendell Behavioral Services of Arkansas100 Rivendell Drive, Benton, AR 72015Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
George H Brunner Individual Corporate OfficerAssistant Secretary May 1, 2004 100%
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary May 1, 2004 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Timothy K Smith Individual Contracted Managing EmployeeCfo Jul 20, 2020
Corporate OfficerCfo Jul 20, 2020
Steve Filton Individual Corporate OfficerVP, Board Member May 1, 2004 100%
Corporate DirectorVP, Board Member May 17, 2004 33.33%
Operational/Managerial ControlVP, Board Member May 1, 2004 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer May 1, 2004 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Direct Ownership Interest May 1, 2004
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager May 1, 2004 50%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation Operational/Managerial Control May 1, 2004 100%
Fredrick L Knox Individual Contracted Managing EmployeeCeo Sep 16, 2020
Corporate OfficerCeo Sep 16, 2020
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman Mar 25, 2022 86.5%

Facilities with the same owner 172

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

View all 172

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1063482735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720159188",
            "telephone_number": "501-316-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720159188",
            "telephone_number": "501-316-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UHS OF BENTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SR VP  CFO",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "AR",
            "license": "AR4219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154265125",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivendell Behavioral Health Services of Arkansas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.