Witham Memorial Hospital

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WITHAM MEMORIAL HOSPITAL

Doing business as

Witham Health Services

Practice address

2605 N Lebanon St
Lebanon, IN 46052-1476

Phone

(765) 485-8000

NPI assigned

Jan 29, 2007

Last updated

Jul 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Braverman

Title

Ceo, President

Phone

(765) 485-8100

Specialties & licenses 1

Addresses

Other names 1

• Witham Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Witham Memorial Hospital

  dba Witham Health Services

  • Clinical Medical Laboratory
  • Lebanon, IN
  • NPI 1558493767

  O20040519001402

  Same enrollment
• Witham Memorial Hospital

  dba Witham Rehabilitation Services, Anson at Whitestown

  • Physical Therapist
  • Zionsville, IN
  • NPI 1952282204

  O20040519001402

  Same enrollment
• Witham Memorial Hospital

  dba Witham Health Services

  • Physical Therapist
  • Frankfort, IN
  • NPI 1992276745

  O20040519001402

  Same enrollment

Locations

All facility ownership & control disclosures 32

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 171

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.

• Robert B Arthur, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1376531798
  Medicare reassignment Care Compare group NPD
• Dawn M Ayers, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Zionsville, IN
  • NPI 1306823513
  Medicare reassignment Care Compare group NPD
• Kara Dian Bell, NP

  • Hospitalist Physician
  • Lebanon, IN
  • NPI 1679510440
  Medicare reassignment Care Compare group NPD
• Jessica Marie Bingham, FNP - C

  • Family Nurse Practitioner
  • Lebanon, IN
  • NPI 1427617810
  Medicare reassignment Care Compare group NPD
• Douglas Blacklidge, DPM

  • Foot & Ankle Surgery Podiatrist
  • Kokomo, IN
  • NPI 1003901133
  Medicare reassignment Care Compare group NPD
• Matthew Thomas Bobzien IV, MD

  • Family Medicine Physician
  • Jamestown, IN
  • NPI 1962508812
  Medicare reassignment Care Compare group NPD
• Kevin Boone, NP

  • Nurse Practitioner
  • Lebanon, IN
  • NPI 1376869669
  Medicare reassignment Care Compare group NPD
• James Anthony Boudreau, MD

  • Family Medicine Physician
  • Lebanon, IN
  • NPI 1215923941
  Medicare reassignment Care Compare group NPD
• Benjamin Brewster, MD

  • Surgery Physician
  • Lebanon, IN
  • NPI 1316100423
  Medicare reassignment Care Compare group NPD
• Della J. Busby, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, IN
  • NPI 1215039144
  Medicare reassignment Care Compare group NPD
• Mitchell Lee Carter, FNP

  • Hospitalist Physician
  • Lebanon, IN
  • NPI 1104156801
  Medicare reassignment Care Compare group NPD
• John Michael Chappo, D.O.

  • Internal Medicine Physician
  • Zionsville, IN
  • NPI 1730347022
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1083750293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "BRAVERMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "765-485-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Witham Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neal Williams, LCSW
• Abraham Wilson, RBT
• Craig Jeffrey Wilson, MD
• Si-Ron M Wilson, PTA
• Ted R Winkler, MD
• Witham Memorial Hospital (Boone County EMS)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)

• Family Medicine Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.