NPIMap

Organization Active NPI

Uhs of Parkwood Inc

Doing business as Parkwood Behavioral Health System

  • Psychiatric Hospital
  • Olive Branch, MS
National Provider Identifier
1093785859
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
32316 Issued in MS
Legal business name
UHS OF PARKWOOD INC
Doing business as
Parkwood Behavioral Health System
Practice address
8135 Goodman Rd
Olive Branch, MS 38654-2103
Phone
(662) 895-4900
NPI assigned
Jan 25, 2006
Last updated
Sep 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Mrs. Sandra Wallace
Title
Cfo
Phone
(662) 893-7093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 32316 MS Primary

Addresses

Primary practice location

8135 Goodman Rd
Olive Branch, MS 38654-2103

Mailing address

8135 Goodman Rd
Olive Branch, MS 38654-2103
Phone (662) 895-4900

Other identifiers 2

IdentifierTypeStateIssuer
00220612MedicaidMS
220612MedicaidMS

Other names 1

  • Parkwood Behavioral Health System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101130000762 MS Part B Supplier - Clinic/Group Practice 6002002276 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Olive Branch, MS
O20110630000641 MS Part A Provider - Hospital 6002002276 Practice locations: Olive Branch, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093785859. Details of each certification follow.

Hospital certification: CCN 254005

Legal name
UHS OF PARKWOOD INC
Doing business as
PARKWOOD BEHAVIORAL HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
May 19, 1987
Last certification
Jan 19, 2011
Beds
88
Ownership / control type
Private (for profit)
Most recent change of ownership
Aug 18, 2000 (5 total)
Organization structure
CorporationProprietary
Incorporated
Jun 2, 2000 in DE
Enrollment address
8135 Goodman Road
Parkwood Behavioral Health System
Olive Branch, MS 38654-2103
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Parkwood Behavioral Health SystemCCN 254005 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Uhs of Parkwood Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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 Jun 6, 2011 100%
David M Denegri Individual Contracted Managing EmployeeCfo Jan 20, 2014 100%
Corporate OfficerCfo Jan 20, 2014 100%
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Jun 6, 2011 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%
Steve Filton Individual Corporate OfficerVice President & Board Member Jun 6, 2011
Corporate DirectorVice President & Board Member Jun 6, 2011
Operational/Managerial ControlVice President & Board Member Jun 6, 2011
Alicia R Plunkett Individual Contracted Managing EmployeeCeo Jan 3, 2022
Corporate OfficerCeo Jan 3, 2022
Cheryl K Ramagano Individual Corporate OfficerTreasurer Jun 6, 2011 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Direct Ownership Interest Jun 6, 2011 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Jun 6, 2011 50%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation Operational/Managerial Control Jan 1, 2015 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 18

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 18

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": "1283385600000",
    "number": "1093785859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542103",
            "telephone_number": "662-895-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542103",
            "telephone_number": "662-895-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UHS OF PARKWOOD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-893-7093",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MS",
            "license": "32316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220612",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220612",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkwood Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.