Johnson Memorial Hospital
Organization Active NPI Skilled Nursing Facility · Warsaw, IN
NPI 1114947686 · NPPES record last updated Jan 27, 2022
Key facts
- NPI
- 1114947686
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 06-000017-1 (IN)
- Legal business name
- JOHNSON MEMORIAL HOSPITAL
- Practice address
- 1630 S County Farm Rd
Warsaw, IN 46580-8248 - Phone
- (574) 267-8196
- NPI assigned
- Jul 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Steven J Berkhouse
- Title
- Cfo
- Phone
- (317) 346-7939
Owners & managing parties with NPI records 4
-
David H Dunkle, MD
-
Tina Robinson, MA,CCC-SLP
Corporate family (same tax ID) 36
Facilities with the same owner 112
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Miller'S Merry Manor
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Dec 12, 1967
- Medicare certification status
- Active
- Certified beds
- 137 · 94.5 residents per day on average
- Chain
- Miller'S Merry Manor
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0666086 | Miller'S Merry Manor | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Skilled nursing facility certification: CCN 155049
- Legal name
- JOHNSON MEMORIAL HOSPITAL
- Doing business as
- MILLER'S MERRY MANOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Dec 12, 1967
- Last certification
- Apr 8, 2025
- Beds
- 137
- Ownership / control type
- Corporation
- Multi-facility organization
- Millers Health Systems
- Most recent change of ownership
- Jun 1, 2013
- Organization structure
- Government · Non-profit
- Enrollment address
- 1630 S County Farm Rd
Warsaw, IN 46580-8248 - Nursing home name
- MILLER'S MERRY MANOR
- Affiliated entity
- MILLER'S MERRY MANOR
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Tina Robinson |
Operational/Managerial Control | Jan 1, 2025 | |
| David H Dunkle |
Operational/Managerial Control | Jan 1, 2025 | |
| Lument Finance Trust Inc |
5% Or Greater Mortgage Interest | Nov 1, 2014 | 79% |
| Miller'S Health Systems Inc |
Operational/Managerial Control | Jun 1, 2013 | |
| Adp of the SNF | Jun 1, 2013 | ||
| Theracare Inc |
Operational/Managerial Control | Jan 1, 2025 | |
| Miller'S Merry Manor Warsaw LLC |
Adp of the SNF | Jun 1, 2013 | |
| Rebecca Jane Johnson |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Aug 11, 2025 | ||
| MMM-Invest Inc |
Adp of the SNF | Jun 1, 2023 | |
| Forvis Mazars LLP |
Operational/Managerial Control | Jun 1, 2013 | |
| Adp of the SNF | Jun 1, 2013 | ||
| Johnson Memorial Hospital |
5% Or Greater Direct Ownership Interest | Jun 1, 2013 | 100% |
| Robert J Decola |
Operational/Managerial Control | Jan 1, 2025 | |
| Patrick H Boyle |
Operational/Managerial Control | Jan 1, 2025 | |
| Hillary Corbitt |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Lori a Haug |
Operational/Managerial Control | Jan 1, 2025 |
All facility ownership & control disclosures 34
| Facility | Type | Role | Since |
|---|---|---|---|
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jul 1, 2012 Jun 1, 2013 Jun 1, 2013 |
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2013 |
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| The Waters of Lagrange Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Dunkirk Skilled Nursing Facilty |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Sullivan Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Rushville Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Syracuse Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Tipton Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Peru Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Rockport Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Chesterfield Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Fort Wayne Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Wakarusa Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Hartford City Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Columbia City Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Castleton Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Middletown Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Huntington Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| The Waters of Hobart Skilled Nursing Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2013 |
| Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2013 |
| Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2013 |
| Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2013 |
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2023 |
| Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2013 |
| Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2013 |
| Millers at Oak Pointe |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2014 |
| The Waters of Wabash Skilled Nursing Facility East |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| The Waters of Wabash Skilled Nursing Facility West |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Oct 1, 2015 Jun 1, 2013 Jun 1, 2013 |
| Millers Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2013 |
| Greenwood Village South |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Nov 1, 2016 Nov 1, 2016 Jul 9, 2025 |
| Miller'S Health & Rehab by Miller'S Merry Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jun 1, 2013 Jun 1, 2013 Jun 1, 2013 |
| Compass Park |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jan 1, 2023 Jan 1, 2023 Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130725000467 | IN | Part a Provider - Skilled Nursing Facility | 8527972595 | Practice locations: Warsaw, IN |
National Provider Directory
- Tax ID family
- Emergency Medical Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 06-000017-1 | IN | Yes |
| Nursing Facility Supplies (DME) | 332BN1400X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | IN |
Addresses
Primary practice location
1630 S County Farm Rd
Warsaw, IN 46580-8248
Mailing address
1125 W Jefferson St
Franklin, IN 46131-2140
Phone (317) 736-3396
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100273830A | Medicaid | IN |
Other names
- Miller's Merry Manor
Other providers in Warsaw, IN
- Mark A Jensen
- Abigail Lee Jessie
- Staci Jesuit
- Joes Kids Inc
- Johnson Chiropractic, Inc
- Matthew G Johnson
- Nathaniel Lee Johnson
- Rachel L Johnson
- Shannon Marie Johnson
- Carmen Johnston
All providers in Warsaw, IN · Skilled Nursing Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.