Active NPI
RBRC, Inc.
Doing business as Rivers Bend Retirement Community
- Skilled Nursing Facility
- Kuttawa, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 100686
- Legal business name
- RBRC, INC.
- Doing business as
- Rivers Bend Retirement Community
- Practice address
- 300 Beech St
Kuttawa, KY 42055-6214 - Phone
- (270) 388-2868
- Fax
- (270) 388-2945
- NPI assigned
- Feb 20, 2006
- Last updated
- Aug 14, 2008
- 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. David T. Beaven
- Title
- Cfo
- Phone
- (270) 822-4218
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 20010207201 | KY | |
| Custodial Care Facility | 311Z00000X | 750050 | KY | |
| Skilled Nursing Facility | 314000000X | 100686 | KY | Primary |
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 100686 | KY |
Addresses
Primary practice location
300 Beech St
Kuttawa, KY 42055-6214
Mailing address
PO Box 127
Uniontown, KY 42461-0127
Phone (270) 822-4218
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1233760001 | Other | KY | PART B SUPPLIER NUMBER |
| 43020726 | Medicaid | KY | |
| 12503652 | Medicaid | KY |
Other names 1
- Rivers Bend Retirement Community
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070807000024 | KY | Part A Provider - Skilled Nursing Facility | 8921199977 | Practice locations: Kuttawa, KY |
NPI to CCN mapping 2
The Medicare certification numbers (CCNs) connected to NPI 1508831033. Details of each certification follow.
Skilled nursing facility certification: CCN 185410
- Legal name
- RBRC, INC.
- Doing business as
- RIVER'S BEND RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jun 29, 1995
- Last certification
- Sep 8, 2023
- Beds
- 40
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Guardian Foundation
- Organization structure
- Corporation
- Incorporated
- Dec 19, 1997 in KY
- Enrollment address
- 300 Beech St
Kuttawa, KY 42055-6214 - Nursing home name
- RIVER'S BEND RETIREMENT COMMUNITY
Outpatient physical therapy / speech pathology certification: CCN 186684
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
- RIVERS BEND RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Outpatient physical therapy / speech pathology
- Participating since
- Jan 7, 2015
- Last certification
- Jan 7, 2015
- Ownership / control type
- VOLUNTARY NON PROFIT OTHER THAN CHURCH
- Facility address
- 300 Beech Street
Kuttawa, KY 42055
Care Compare: Nursing home
Medicare Care Compare- Listed as
- River's Bend Retirement Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jun 29, 1995
- Medicare certification status
- Active
- Certified beds
- 40
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D0907577 | Rivers Bend Retirement Community | Certificate of waiver | Oct 16, 2027 |
| 18D2201925 | Rivers Bend Retirement Community | Certificate of waiver | Nov 23, 2026 |
| 18D2202814 | Rivers Bend Retirement Community Assisted | Certificate of waiver | Nov 30, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Stacey D Bullock | Contracted Managing Employee | Jan 18, 2018 | 100% |
| Operational/Managerial Control | Jan 18, 2018 | 100% | |
| William F Rowe | Corporate Officer | Nov 1, 2010 | |
| Mark a Waldrop | Corporate Officer | Jan 1, 2021 | 100% |
| Corporate Director | Jan 1, 2021 | 100% | |
| Arthur C Delozier | Corporate Director | Jun 12, 2013 | |
| Gregory K Grove | Corporate Director | Aug 11, 1994 | |
| Timothy a Duggan | Corporate Director | Jul 1, 2010 |
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Medicine Physician
- Kuttawa, KY
- NPI 1174513915
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218672000000",
"number": "1508831033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 127",
"city": "UNIONTOWN",
"state": "KY",
"postal_code": "424610127",
"telephone_number": "270-822-4218",
"fax_number": "270-822-4210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BEECH ST",
"city": "KUTTAWA",
"state": "KY",
"postal_code": "420556214",
"telephone_number": "270-388-2868",
"fax_number": "270-388-2945"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RBRC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-20",
"last_updated": "2008-08-14",
"status": "A",
"authorized_official_last_name": "BEAVEN",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "T.",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "270-822-4218",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "KY",
"license": "20010207201",
"primary": false
},
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": "KY",
"license": "750050",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KY",
"license": "100686",
"primary": true
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "KY",
"license": "100686",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PART B SUPPLIER NUMBER",
"identifier": "1233760001",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43020726",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12503652",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rivers Bend Retirement Community",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kuttawa, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.