NPIMap

Organization Active NPI

Commonwealth Health Corporation

  • Neurology Physician
  • Bowling Green, KY
National Provider Identifier
1306046115
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
18710 Issued in KY
Legal business name
COMMONWEALTH HEALTH CORPORATION
Practice address
825 2ND Ave
Suite A3
Bowling Green, KY 42101-1786
Phone
(270) 796-6847
Fax
(270) 796-6841
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Ronald G. Sowell
Title
Exec. Vice President
Phone
(270) 745-1536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 18710 KY Primary

Addresses

Primary practice location

825 2ND Ave
Suite A3
Bowling Green, KY 42101-1786

Mailing address

PO Box 2697
Bowling Green, KY 42102-7697
Phone (270) 745-1467

Other identifiers 1

IdentifierTypeStateIssuer
65931776MedicaidKY

Other names 1

  • ATTENDING PHYSICIAN WALTER WARREN Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916000800 KY Part B Supplier - Clinic/Group Practice 5496667628 Receives reassigned benefits from 306 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 42

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

View all 42

National Provider Directory

National Provider Directory

Locations

825 2nd Ave
Ste A3
Bowling Green, KY 42101
Phone (270) 796-6847

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1306046115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2697",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421027697",
            "telephone_number": "270-745-1467",
            "fax_number": "270-745-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 2ND AVE",
            "address_2": "SUITE A3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011786",
            "telephone_number": "270-796-6847",
            "fax_number": "270-796-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "SOWELL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXEC. VICE PRESIDENT",
        "authorized_official_telephone_number": "270-745-1536"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "18710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65931776",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATTENDING PHYSICIAN WALTER WARREN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.