NPIMap

Organization Active NPI

Commonwealth Health Corporation

  • Psychiatry Physician
  • Bowling Green, KY
National Provider Identifier
1467482299
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COMMONWEALTH HEALTH CORPORATION
Practice address
350 Park St
Suite 204
Bowling Green, KY 42101-1784
Phone
(270) 843-5103
Fax
(270) 843-5104
NPI assigned
Jul 4, 2006
Last updated
Sep 7, 2007By the provider in NPPES
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
Executive Vice President
Phone
(270) 745-1536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X KY Primary

Addresses

Primary practice location

350 Park St
Suite 204
Bowling Green, KY 42101-1784

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
65931776MedicaidKY

Other names 1

  • ATTENDING PHYSICIANS CHANI, MULLICK & GRAU 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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1467482299",
    "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": "350 PARK ST",
            "address_2": "SUITE 204",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-843-5103",
            "fax_number": "270-843-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "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": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "270-745-1536"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65931776",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATTENDING PHYSICIANS CHANI, MULLICK & GRAU",
            "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.