Organization Active NPI

Southern Kentucky Surgicenter, LLC

Doing business as Greenview Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bowling Green, KY
National Provider Identifier
1063999662
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTHERN KENTUCKY SURGICENTER, LLC
Doing business as
Greenview Surgery Center
Practice address
484 Golden Autumn Way
Suite 100
Bowling Green, KY 42103
Phone
(270) 938-6500
NPI assigned
Jul 26, 2018
Last updated
Sep 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
David McKnight
Title
VP/Cfo
Phone
(972) 789-2816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

484 Golden Autumn Way
Suite 100
Bowling Green, KY 42103

Mailing address

484 Golden Autumn Way Ste 100
Bowling Green, KY 42103-6914

Other names 1

  • Greenview Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181102000793 KY Part B Supplier - Ambulatory Surgical Center 1052664398 Practice locations: Bowling Green, KY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Southern Kentucky Surgicenter LLC Dba Greenview Surgery CenterCCN 18C0001053
Medicare certification status
ActiveFrom the Provider of Services file

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
18D2156338Greenview Surgery Center484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103Certificate of waiverOct 15, 2026

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1063999662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 GOLDEN AUTUMN WAY STE 100",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 GOLDEN AUTUMN WAY",
            "address_2": "SUITE 100",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-938-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KENTUCKY SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenview Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greenview Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.