NPIMap

Organization Active NPI

Wellstone Regional Hospital Acquisition LLC

Doing business as Wellstone Regional Hospital

  • Psychiatric Hospital
  • Jeffersonville, IN
National Provider Identifier
1841215985
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
61100451A Issued in IN
Legal business name
WELLSTONE REGIONAL HOSPITAL ACQUISITION LLC
Doing business as
Wellstone Regional Hospital
Practice address
2700 Vissing Park Rd
Jeffersonville, IN 47130-5989
Phone
(812) 284-8000
Fax
(812) 704-1221
NPI assigned
Jul 12, 2006
Last updated
Apr 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Authorized official

Name
Steve Filton
Title
SRVP Cfo
Phone
(610) 768-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU
Psychiatric Hospital 283Q00000X 61100451A IN Primary

Addresses

Primary practice location

2700 Vissing Park Rd
Jeffersonville, IN 47130-5989

Mailing address

2700 Vissing Park Rd
Jeffersonville, IN 47130-5989
Phone (812) 284-8000

Other identifiers 3

IdentifierTypeStateIssuer
200813230AMedicaidIN
200813990AMedicaidIN
02000057MedicaidKY

Other names 1

  • Wellstone Regional Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051227000575 IN Part A Provider - Hospital 3577585066 Practice locations: Jeffersonville, IN
O20070608000026 IN Part B Supplier - Clinic/Group Practice 3577585066 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jeffersonville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841215985. Details of each certification follow.

Hospital certification: CCN 154051

Legal name
WELLSTONE REGIONAL HOSPITAL ACQUISITION LLC
Doing business as
WELLSTONE REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 12, 2003
Last certification
Jun 13, 2008
Beds
100
Ownership / control type
Private (for profit)
Most recent change of ownership
Jan 1, 2006 (1 total)
Organization structure
LLCProprietary
Incorporated
Jun 15, 2005 in IN
Enrollment address
2700 Vissing Park Road
Jeffersonville, IN 47130-5989
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Wellstone Regional HospitalCCN 154051 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
BHC Holdings Inc Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Dec 4, 2006 100%
George H Brunner Individual Corporate OfficerAssistant Secretary Nov 15, 2010 100%
Angela G Doan Individual Contracted Managing EmployeeCfo Oct 26, 2020
Corporate OfficerCfo Oct 26, 2020
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Nov 15, 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 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President Nov 15, 2010 100%
Corporate DirectorVice President Nov 15, 2010 33.3%
Operational/Managerial ControlVice President Nov 15, 2010 100%
Behavioral Healthcare LLC Organization, King of Prussia, PA LLC 5% Or Greater Direct Ownership Interest Dec 4, 2006 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Nov 15, 2010 100%
Jessica Campbell Individual Contracted Managing EmployeeCeo Jun 3, 2024
Corporate OfficerCeo Jun 3, 2024
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Nov 15, 2010 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Nov 15, 2010 50%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation Operational/Managerial Control Nov 15, 2010 100%
Psychiatric Solutions, Inc. Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Dec 4, 2006 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 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1841215985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 VISSING PARK RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305989",
            "telephone_number": "812-284-8000",
            "fax_number": "812-704-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VISSING PARK RD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305989",
            "telephone_number": "812-284-8000",
            "fax_number": "812-704-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTONE REGIONAL HOSPITAL ACQUISITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SRVP CFO",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IN",
            "license": "61100451A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200813230A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200813990A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02000057",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellstone Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.