NPIMap

Organization Active NPI

Uhs of Lakeside LLC

Doing business as Lakeside Behavioral Health System

  • Psychiatric Hospital
  • Memphis, TN
National Provider Identifier
1083687651
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
230 Issued in TN
Legal business name
UHS OF LAKESIDE LLC
Doing business as
Lakeside Behavioral Health System
Practice address
2911 Brunswick Rd
Memphis, TN 38133-4105
Phone
(901) 377-4700
NPI assigned
Feb 13, 2006
Last updated
Aug 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 230 TN Primary

Addresses

Primary practice location

2911 Brunswick Rd
Memphis, TN 38133-4105

Mailing address

2911 Brunswick Rd
Memphis, TN 38133-4105
Phone (901) 377-4700

Other identifiers 1

IdentifierTypeStateIssuer
131599140MedicaidTN

Other names 1

  • Lakeside Behavioral Health System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101013000171 TN Part A Provider - Hospital 7315078029 Practice locations: Memphis, TN
O20180508002414 TN Part B Supplier - Clinic/Group Practice 7315078029 Receives reassigned benefits from 9 practitioners
Practice locations: Bartlett, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083687651. Details of each certification follow.

Hospital certification: CCN 444004

Legal name
UHS OF LAKESIDE LLC
Doing business as
LAKESIDE BEHAVIORAL HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
May 23, 1973
Last certification
Mar 21, 2007
Beds
290
Ownership / control type
Church
Organization structure
LLCProprietary
Incorporated
Apr 30, 2009 in DE
Enrollment address
2911 Brunswick Road
Memphis, TN 38133-4105
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Lakeside Behavioral Health SystemCCN 444004 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Church
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
44D0940782Lakeside Behavioral Health System2911 Brunswick Road, Memphis, TN 38133Certificate of waiverFeb 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Uhs of Lakeside LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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 Jul 9, 2010 100%
Johnta D Johnson Individual Contracted Managing EmployeeCfo Jul 1, 2023
Corporate OfficerCfo Jul 1, 2023
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Oct 1, 2010 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 21, 2021 100%
Corporate DirectorVice President Jul 21, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President Jul 9, 2010 100%
Corporate DirectorVice President Jul 9, 2010 33.3%
Operational/Managerial ControlVice President Jul 9, 2010 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Jul 9, 2010 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 30, 2009 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Jul 9, 2010 50%
David Morris Individual Contracted Managing EmployeeCeo Dec 16, 2024
Corporate OfficerCeo Dec 16, 2024
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office Operational/Managerial Control Jul 9, 2010 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman Mar 18, 2024 87.4%

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 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1083687651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 BRUNSWICK RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381334105",
            "telephone_number": "901-377-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 BRUNSWICK RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381334105",
            "telephone_number": "901-377-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UHS OF LAKESIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO/ SR VP",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TN",
            "license": "230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131599140",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.