NPIMap

Organization Active NPI

Witham Memorial Hospital

  • Skilled Nursing Facility
  • New Albany, IN
National Provider Identifier
1124360367
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WITHAM MEMORIAL HOSPITAL
Practice address
1 Silvercrest Dr
New Albany, IN 47150-7800
Phone
(812) 542-6720
NPI assigned
Mar 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1 Silvercrest Dr
New Albany, IN 47150-7800

Mailing address

PO Box 221648
Louisville, KY 40252-1648
Phone (502) 412-5847

Other identifiers 1

IdentifierTypeStateIssuer
201238590MedicaidIN

Other names 1

  • The Villages at Historic Silvercrest Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151006000814 IN Part A Provider - Skilled Nursing Facility 4082523170 Practice locations: New Albany, IN

Skilled nursing facility certification: CCN 155813

Legal name
WITHAM MEMORIAL HOSPITAL
Doing business as
THE VILLAGES AT HISTORIC SILVERCREST
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 25, 2013
Last certification
Jul 22, 2024
Beds
108 (56 certified)
Ownership / control type
Corporation
Multi-facility organization
Trilogy Health Services
Organization structure
GovernmentNon-profit
Enrollment address
1 Silvercrest Dr
New Albany, IN 47150-7800
Nursing home name
VILLAGES AT HISTORIC SILVERCREST THE
Affiliated entity
TRILOGY HEALTH SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Villages at Historic Silvercrest theCCN 155813
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 25, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5648.4 residents per day on average
Chain
Trilogy Health Services123 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2062005BD Trustees of Flavius J Witham Mem Hosp1 Silvercrest Dr, New Albany, IN 47150Certificate of waiverJul 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hoosier Enterprises II Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Trilogy Healthcare of Floyd LLC Organization, Louisville, KY LLC, For-profit Operational/Managerial Control Jan 1, 2015 100%
Kelly Braverman Individual Corporate OfficerCeo, President Dec 1, 2021 100%
Stephen J Bardoczi Individual W-2 Managing EmployeeVice President Sep 2, 2013 100%
Witham Memorial Hospital Organization, Lebanon, IN 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
George Pogas Individual Corporate OfficerCfo, Sr. Vice President Nov 12, 2002 100%
Michael Jason Hornbecker Individual Corporate DirectorBoard Trusted Jan 1, 2024
Andrea Castetter Individual Corporate DirectorBoard Trustee Jan 1, 2023
Claude a Hawkins Individual Corporate DirectorBoard Trustee Sep 9, 2013
John W Brand Individual Corporate DirectorBoard Trustee Jan 1, 2015
Brett Bayston Individual Corporate DirectorBoard Trustee Jan 1, 2023

All facility ownership & control disclosures 31

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

FacilityTypeRoleSince
Witham Health ServicesLebanon, IN, CCN 150104 Hospital Operational/Managerial Control (100%) Nov 24, 2011
Ambassador HealthcareCenterville, IN, CCN 155490 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2011
Vermillion Convalescent CenterClinton, IN, CCN 155124 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Twin City HealthcareGas City, IN, CCN 155232 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Westridge Health Care CenterTerre Haute, IN, CCN 155234 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Persimmon Ridge Rehabilitation CentrePortland, IN, CCN 155526 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Grand Valley Health & RehabMartinsville, IN, CCN 155605 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Willow Crossing Health & Rehabilitation CenterColumbus, IN, CCN 155535 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Pineknoll Rehabilitation CentreWinchester, IN, CCN 155527 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Camelot Care CenterLogansport, IN, CCN 155385 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Alexandria Care CenterAlexandria, IN, CCN 155521 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2012
White Oak Health CampusMonticello, IN, CCN 155782 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
St Mary Healthcare CenterLafayette, IN, CCN 155094 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Waterford Place Health CampusKokomo, IN, CCN 155678 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Cumberland Pointe Health CampusWest Lafayette, IN, CCN 155775 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Blair Ridge Health CampusPeru, IN, CCN 155791 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Woodbridge Health CampusLogansport, IN, CCN 155724 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Greenleaf Health CampusElkhart, IN, CCN 155783 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
St Elizabeth Healthcare CenterDelphi, IN, CCN 155290 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Homewood Health CampusLebanon, IN, CCN 155680 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Arlington Place Health CampusIndianapolis, IN, CCN 155816 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Wellbrooke of WabashWabash, IN, CCN 155806 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Wellbrooke of KokomoKokomo, IN, CCN 155819 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
The Springs at LafayetteLafayette, IN, CCN 155829 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Wellbrooke of CarmelCarmel, IN, CCN 155833 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Clearvista Lake Health CampusIndianapolis, IN, CCN 155815 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
McGivney Health Care CenterCarmel, IN, CCN 155855 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Brooke Knoll VillageAvon, IN, CCN 155814 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
Westminster Village KentuckianaClarksville, IN, CCN 155191 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2023
Suburban Home Health, LLCNoblesville, IN, CCN 157092 Home health agency 5% Or Greater Indirect Ownership Interest (10.27%) Sep 3, 2024
Suburban HospiceNoblesville, IN, CCN 151547 Hospice 5% Or Greater Indirect Ownership Interest (10.27%) Nov 1, 2024

Facilities with the same owner 31

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 31

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648252800000",
    "number": "1124360367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221648",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402521648",
            "telephone_number": "502-412-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SILVERCREST DR",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471507800",
            "telephone_number": "812-542-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201238590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Villages at Historic Silvercrest",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Villages at Historic Silvercrest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.