NPIMap

Organization Active NPI

Uhs of Bowling Green LLC

Doing business as Rivendell of Kentucky

  • Psychiatric Hospital
  • Bowling Green, KY
National Provider Identifier
1396715967
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
100564 Issued in KY
Legal business name
UHS OF BOWLING GREEN LLC
Doing business as
Rivendell of Kentucky
Practice address
1035 Porter Pike Rd
Bowling Green, KY 42103-9581
Phone
(270) 843-1199
NPI assigned
Jan 25, 2006
Last updated
Jan 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 100564 KY
Psychiatric Hospital 283Q00000X 100564 KY Primary
Rehabilitation Hospital 283X00000X 100564 KY
Children's Rehabilitation Hospital 283XC2000X 100564 KY
Special Hospital 284300000X 100564 KY
Nurse Practitioner 363L00000X 100564 KY
Long Term Care Hospital 282E00000X 100564 KY

Addresses

Primary practice location

1035 Porter Pike Rd
Bowling Green, KY 42103-9581

Mailing address

1035 Porter Pike Rd
Bowling Green, KY 42103-9581
Phone (270) 843-1199

Other identifiers 6

IdentifierTypeStateIssuer
45002284MedicaidKY
29200094MedicaidKY
65941296MedicaidKY
29100096MedicaidKY
02000024MedicaidKY
000000330593OtherKYBLUE CROSS

Other names 1

  • Rivendell of Kentucky Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040517000559 KY Part A Provider - Hospital 7810987336 Practice locations: Bowling Green, KY
O20131004000238 KY Part B Supplier - Clinic/Group Practice 7810987336 Receives reassigned benefits from 16 practitioners
Practice locations: Woodburn, KY; Brownsville, KY; Bowling Green, KY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1396715967. Details of each certification follow.

Hospital certification: CCN 184017

Legal name
UHS OF BOWLING GREEN LLC
Doing business as
RIVENDELL BEHAVIORAL HEALTH SERVICES OF KENTUCKY
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jun 5, 1997
Last certification
May 14, 2008
Beds
84
Ownership / control type
Federal
Most recent change of ownership
May 1, 2004 (1 total)
Organization structure
LLCProprietary
Incorporated
Mar 25, 2004 in DE
Enrollment address
1035 Porter Pike
Bowling Green, KY 42103-9581
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Hospital certification: CCN 184016

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RIVENDELL PSYCHIATRIC CENTER
Certification status
Terminated Voluntary: merger or closure, Jun 2, 1997
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 7, 1989
Last certification
Oct 17, 1996
Beds
72
Ownership / control type
Private (for profit)
Facility address
1035 Porter Pike
Bowling Green, KY 42103

Care Compare: Hospital

Medicare Care Compare
Listed as
Rivendell Behavioral Health ServicesCCN 184017 · All quality measures
Type
Psychiatric
Ownership
Government - Federal
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
18D0714369Rivendell Behavioral Health Services of Ky1035 Porter Pike, Bowling Green, KY 42103Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1035 Porter Pike
Bowling Green, KY 42103
Phone (270) 843-1199

1800 Westen St
Bowling Green, KY 42104
Phone (270) 746-5502

200 Natchez Trace Ave
Bowling Green, KY 42103
Phone (270) 843-1199

2365 Nashville Rd
Bowling Green, KY 42101
Phone (270) 745-9884

Ownership & related parties

All disclosed owners & managing parties 12

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 2, 2000 100%
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%
Jeremy Michael Wagoner Individual Contracted Managing EmployeeCeo Jun 17, 2024
Corporate OfficerCeo Jun 17, 2024
Steve Filton Individual Corporate OfficerVice President Jun 2, 2000 100%
Corporate DirectorVice President Jun 2, 2000 33.3%
Operational/Managerial ControlVice President Jun 2, 2000 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Jun 2, 2000 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Direct Ownership Interest Jun 2, 2000 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursment Manager Jun 2, 2000 50%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation Operational/Managerial Control Jun 2, 2000 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 23

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 23

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": "1358899200000",
    "number": "1396715967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PORTER PIKE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421039581",
            "telephone_number": "270-843-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PORTER PIKE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421039581",
            "telephone_number": "270-843-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UHS OF BOWLING GREEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-01-23",
        "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": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "KY",
            "license": "100564",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "KY",
            "license": "100564",
            "primary": true
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "KY",
            "license": "100564",
            "primary": false
        },
        {
            "code": "283XC2000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital, Children",
            "state": "KY",
            "license": "100564",
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "KY",
            "license": "100564",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "100564",
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "KY",
            "license": "100564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45002284",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29200094",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65941296",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29100096",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02000024",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000330593",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivendell of Kentucky",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.