Active NPI
West Liberty Care Center Inc
Doing business as Green Hills Center
- Skilled Nursing Facility
- West Liberty, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1637N
- Legal business name
- WEST LIBERTY CARE CENTER INC
- Doing business as
- Green Hills Center
- Practice address
- 6557 US Highway 68 S
West Liberty, OH 43357-9536 - Phone
- (937) 465-5065
- Fax
- (937) 465-4390
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael S Ray
- Title
- Ceo
- Phone
- (937) 465-5065
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 1637R | OH | |
| Alzheimer Center (Dementia Center) | 311500000X | 1637N | OH | |
| Skilled Nursing Facility | 314000000X | 1637N | OH | Primary |
Addresses
Primary practice location
6557 US Highway 68 S
West Liberty, OH 43357-9536
Mailing address
6557 US Highway 68 S
West Liberty, OH 43357-9536
Phone (937) 465-5065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0349742 | Medicaid | OH |
Other names 1
- Green Hills Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110310000375 | OH | Part A Provider - Skilled Nursing Facility | 1850573916 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: West Liberty, OH |
Skilled nursing facility certification: CCN 365362
- Legal name
- WEST LIBERTY CARE CENTER INC
- Doing business as
- OTTERBEIN GREEN HILLS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 13, 1977
- Last certification
- Jul 13, 2023
- Beds
- 74
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Nov 1, 1972 in OH
- Enrollment address
- 6557 US Highway 68 S
West Liberty, OH 43357-9536 - Nursing home name
- GREEN HILLS CENTER
- Affiliated entity
- OTTERBEIN SENIORLIFE
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Otterbein Green Hills
- Skilled Nursing Facility
- West Liberty, OH
- NPI 1023824679
O20110310000375
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Green Hills Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Oct 13, 1977
- Medicare certification status
- Active
- Certified beds
- 74
- Chain
- Otterbein Seniorlife
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Richard Gildow | Corporate Director | Dec 23, 2024 | |
| Steven Jay Godwin | Corporate Director | Dec 23, 2024 | |
| Barbara Haushalter | Corporate Director | Dec 23, 2024 | |
| Valerie Jean Jones | Corporate Director | Dec 23, 2024 | |
| Jason E Miller | Corporate Officer | Dec 23, 2024 | |
| John Bodin | Corporate Director | Jan 26, 2012 | |
| Amanda Goble | Corporate Director | Dec 23, 2024 | |
| Otterbein LSC, LLC | 5% Or Greater Direct Ownership Interest | Dec 23, 2024 | 100% |
| Adp of the SNF | Dec 23, 2024 | ||
| Charles Vernon Kratz | Operational/Managerial Control | Dec 23, 2024 | |
| Adp of the SNF | Dec 23, 2024 | ||
| Jill Wilson | Corporate Officer | Dec 23, 2024 | |
| Thomas Simon | Corporate Director | Jan 1, 2017 | |
| Nicole C Daniels | Operational/Managerial Control | Jul 1, 2025 | |
| Tony Burtchin | Corporate Director | Dec 23, 2024 | |
| Otterbein Home | 5% Or Greater Indirect Ownership Interest | Dec 23, 2023 | 100% |
| Adp of the SNF | Dec 23, 2024 | ||
| James Christopher Green | Corporate Officer | Dec 23, 2024 | |
| Alexander Richard Dye | Corporate Director | Dec 23, 2024 | |
| Amber Swords | Corporate Director | Oct 22, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- West Liberty, OH
- NPI 1164458410
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- West Liberty, OH
- NPI 1164458410
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- West Liberty, OH
- NPI 1225789902
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607558400000",
"number": "1487686218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6557 US HIGHWAY 68 S",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433579536",
"telephone_number": "937-465-5065",
"fax_number": "937-465-4390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6557 US HIGHWAY 68 S",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433579536",
"telephone_number": "937-465-5065",
"fax_number": "937-465-4390"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST LIBERTY CARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-06",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A",
"authorized_official_last_name": "RAY",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "937-465-5065",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "OH",
"license": "1637R",
"primary": false
},
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": "OH",
"license": "1637N",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "1637N",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0349742",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Green Hills Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in West Liberty, OH
- Joshua J Usserman, APRN-CNP
- Sara J Varner
- Lindsay Walker
- Lori Ann Wallace, LPN
- Paul Dale Warrick-Schkolnik, PHD
- West Liberty Care Center Inc (Green Hills Center - Daybreak)
- West Liberty Care Center Inc (Green Hills Inn)
- West Liberty Care Center, Inc. (Otterbein Green Hills)
- West Liberty Care Center, Inc. (Otterbein Green Hills- Adult Day Care Center)
- West Liberty Care Center, Inc. (Green Hills Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.