Active NPI
Witham Memorial Hospital
- Skilled Nursing Facility
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 08-000037-1
- Legal business name
- WITHAM MEMORIAL HOSPITAL
- Practice address
- 2201 Cason St
Lafayette, IN 47904-2613 - Phone
- (765) 447-4102
- Fax
- (765) 447-7386
- NPI assigned
- Dec 12, 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
- Kelly Braverman
- Title
- Ceo, President
- Phone
- (765) 485-8100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 08-000037-1 | IN | Primary |
Addresses
Primary practice location
2201 Cason St
Lafayette, IN 47904-2613
Mailing address
PO Box 221648
Louisville, KY 40252-1648
Phone (502) 412-5847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100291350 | Medicaid | IN |
Other names 1
- St. Mary Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141204000032 | IN | Part A Provider - Skilled Nursing Facility | 4082523170 | Practice locations: Lafayette, IN |
Skilled nursing facility certification: CCN 155094
- Legal name
- WITHAM MEMORIAL HOSPITAL
- Doing business as
- ST MARY HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- May 26, 1969
- Last certification
- May 19, 2025
- Beds
- 79
- Ownership / control type
- Corporation
- Multi-facility organization
- Trilogy Healthcare Services
- Organization structure
- Other
- Enrollment address
- 2201 Cason St
Lafayette, IN 47904-2613 - Nursing home name
- ST MARY HEALTHCARE CENTER
- Affiliated entity
- TRILOGY HEALTH SERVICES
National Provider Directory
National Provider Directory- Tax ID family
- Hoosier Enterprises II Inc
Other organizations with this tax ID 36
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatric Skilled Nursing Facility
- Shelbyville, IN
- NPI 1801963053
-
- Skilled Nursing Facility
- Martinsville, IN
- NPI 1013926823
-
- Skilled Nursing Facility
- New Albany, IN
- NPI 1124360367
-
- Skilled Nursing Facility
- Wabash, IN
- NPI 1144564626
-
- Skilled Nursing Facility
- Carmel, IN
- NPI 1194115386
-
- Skilled Nursing Facility
- Elkhart, IN
- NPI 1205153269
-
- Skilled Nursing Facility
- Gas City, IN
- NPI 1235316142
-
- Skilled Nursing Facility
- Alexandria, IN
- NPI 1245399500
-
- Skilled Nursing Facility
- Winchester, IN
- NPI 1275732950
-
- Skilled Nursing Facility
- Monticello, IN
- NPI 1306165915
-
- Skilled Nursing Facility
- Terre Haute, IN
- NPI 1316061575
-
- Skilled Nursing Facility
- Kokomo, IN
- NPI 1336225622
Locations
2201 Cason St
Lafayette, IN 47904
Phone (765) 447-4102
Ownership & related parties
All disclosed owners & managing parties 32
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 |
|---|---|---|---|
| Trilogy Healthcare of Lake, LLC | Operational/Managerial Control | Nov 1, 2014 | 100% |
| Julie Reagan | Corporate Director | Sep 25, 2024 | |
| American Healthcare Reit Inc | Adp of the SNF | Oct 1, 2018 | |
| Trilogy Real Estate of Lafayette, LLC | Adp of the SNF | Mar 1, 2009 | |
| Kelly Braverman | Corporate Officer | Dec 1, 2021 | 100% |
| Holly Grenard | Operational/Managerial Control | Mar 7, 2022 | |
| Adp of the SNF | Jul 7, 2025 | ||
| Trilogy Real Estate Investment Trust | Adp of the SNF | Dec 1, 2015 | |
| Trilogy Reit Holdings LLC | Adp of the SNF | Dec 1, 2015 | |
| Stephen J Bardoczi | Corporate Officer | Sep 3, 2013 | |
| John M Thomas | Operational/Managerial Control | Jul 15, 2025 | |
| Adp of the SNF | Jul 15, 2025 | ||
| Trilogy Management Services LLC | Adp of the SNF | Nov 10, 2025 | |
| Gahc3 Trilogy JV LLC | Adp of the SNF | Dec 1, 2015 | |
| Witham Memorial Hospital | 5% Or Greater Direct Ownership Interest | Nov 1, 2014 | 100% |
| Daniel E Sellers | Corporate Officer | Jun 20, 2024 | |
| American Healthcare Reit Holdings LP | Adp of the SNF | Dec 1, 2015 | |
| Trilogy Healthcare Master Tenant II, LLC | Adp of the SNF | Jul 7, 2025 | |
| Michael Jason Hornbecker | Corporate Director | Jan 1, 2024 | |
| Leigh Ann Barney | Limited Partnership Interest | Dec 1, 2015 | 67.6% |
| Andrea Castetter | Corporate Director | Jan 1, 2023 | |
| Trilogy Health Services LLC | Adp of the SNF | Mar 1, 2009 | |
| Claude a Hawkins | Corporate Director | Sep 1, 2013 | |
| John W Brand | Corporate Director | Jan 1, 2015 | |
| Keybank National Association | 5% Or Greater Mortgage Interest | Apr 27, 2017 | 100% |
| Adp of the SNF | Jul 7, 2025 | ||
| Paragon Outpatient Rehabilitation Services LLC | Adp of the SNF | Dec 1, 2015 | |
| Trilogy Investors LLC | Adp of the SNF | Dec 1, 2015 | |
| Trilogy Healthcare Holdings Inc | Indirect Ownership Interest | Dec 1, 2015 | 100% |
| Trilogy Propco Finance LLC | Adp of the SNF | Mar 1, 2009 | |
| Trilogy Property Holdings LLC | Adp of the SNF | Mar 1, 2009 | |
| Brett Bayston | Corporate Director | Jan 1, 2023 | |
| David W Davis | Limited Partnership Interest | Dec 31, 2019 | 32.4% |
| Continental Merger Sub LLC | Adp of the SNF | Oct 1, 2021 | |
| Gahc4 Trilogy JV LLC | Adp of the SNF | Oct 1, 2018 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Lafayette, IN
- NPI 1336108034
Adp of the SNF, Operational/Managerial Control
-
- Rehabilitation Clinic/Center
- Louisville, KY
- NPI 1871867325
Adp of the SNF
All facility ownership & control disclosures 31
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Witham Health Services | Hospital | Operational/Managerial Control (100%) | Nov 24, 2011 |
| Ambassador Healthcare | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2011 |
| Vermillion Convalescent Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2011 |
| Twin City Healthcare | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2011 |
| Westridge Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2011 |
| Persimmon Ridge Rehabilitation Centre | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2011 |
| Grand Valley Health & Rehab | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2011 |
| Willow Crossing Health & Rehabilitation Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2011 |
| Pineknoll Rehabilitation Centre | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2011 |
| Camelot Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2012 |
| Alexandria Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2012 |
| White Oak Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2014 |
| Waterford Place Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2014 |
| Cumberland Pointe Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| Blair Ridge Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| Woodbridge Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| Greenleaf Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| St Elizabeth Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| Homewood Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2015 |
| Arlington Place Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| Wellbrooke of Wabash | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| Wellbrooke of Kokomo | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| The Villages at Historic Silvercrest | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| The Springs at Lafayette | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| Wellbrooke of Carmel | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| Clearvista Lake Health Campus | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| McGivney Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2015 |
| Brooke Knoll Village | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2021 |
| Westminster Village Kentuckiana | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2023 |
| Suburban Home Health, LLC | Home health agency | 5% Or Greater Indirect Ownership Interest (10.27%) | Sep 3, 2024 |
| Suburban Hospice | 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.
-
- Home Health Agency
- Noblesville, IN
- NPI 1598872939
Witham Memorial Hospital
-
- Community Based Hospice Care Agency
- Noblesville, IN
- NPI 1407963846
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Martinsville, IN
- NPI 1013926823
Witham Memorial Hospital
-
- Skilled Nursing Facility
- New Albany, IN
- NPI 1124360367
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Wabash, IN
- NPI 1144564626
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Carmel, IN
- NPI 1194115386
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Elkhart, IN
- NPI 1205153269
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Gas City, IN
- NPI 1235316142
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Alexandria, IN
- NPI 1245399500
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Winchester, IN
- NPI 1275732950
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Monticello, IN
- NPI 1306165915
Witham Memorial Hospital
-
- Skilled Nursing Facility
- Terre Haute, IN
- NPI 1316061575
Witham Memorial Hospital
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Mary Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- May 26, 1969
- Medicare certification status
- Active
- Certified beds
- 79
- Chain
- Trilogy Health Services
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 |
|---|---|---|---|
| 15D0712199 | BD Trustees of Flavius J Witham Mem Hosp | Certificate of waiver | Aug 31, 2026 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648252800000",
"number": "1174768618",
"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": "2201 CASON ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042613",
"telephone_number": "765-447-4102",
"fax_number": "765-447-7386"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WITHAM MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-12",
"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": "IN",
"license": "08-000037-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100291350",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Mary Healthcare Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St. Mary Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; 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.