NPIMap

Organization Active NPI

Whitley Memorial Hospital, Inc.

Doing business as Parkview Whitley Hospital

  • General Acute Care Hospital
  • Columbia City, IN
National Provider Identifier
1205844495
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
06-005090-1 Issued in IN
Legal business name
WHITLEY MEMORIAL HOSPITAL, INC.
Doing business as
Parkview Whitley Hospital
Practice address
1260 E State Road 205
Columbia City, IN 46725
Phone
(260) 248-9302
Fax
(260) 248-9107
NPI assigned
Aug 3, 2006
Last updated
Mar 2, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WHITLEY MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Mrs. Jessica Lee-Hansen
Title
Cfo
Phone
(312) 388-0125

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 06-005090-1 IN Primary
Institutional Pharmacy 3336I0012X

Addresses

Primary practice location

1260 E State Road 205
Columbia City, IN 46725

Mailing address

PO Box 5600
Fort Wayne, IN 46895-5600
Phone (260) 373-7008

Other identifiers 12

IdentifierTypeStateIssuer
01300664MedicaidKY
4744OtherINPHP IDENTIFICATION #
000000098126OtherINANTHEM IDENTIFICATION #
000000004969OtherINMPLAN IDENTIFICATION #
9422664MedicaidOH
304608369MedicaidMI
000000098126OtherININDIANA COMP. ID#
404608378MedicaidMI
03697300OtherINBLACK LUNG ID#
1509946OtherNCPDP
100268830AMedicaidIN
351965665-001OtherINCHAMPUS IDENTIFICATION #

Other names 1

  • Parkview Whitley Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000024 IN Part A Provider - Hospital 0446278469 1 other NPI on this enrollment
Practice locations: Columbia City, IN; Warsaw, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205844495. Details of each certification follow.

Hospital certification: CCN 150101

Legal name
WHITLEY MEMORIAL HOSPITAL INC
Doing business as
PARKVIEW WHITLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 29, 2016
Beds
30
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1260 E State Road 205
Columbia City, IN 46725-9492
Main/Primary Hospital Location
Hospital subgroups
Acute care

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
Parkview Whitley HospitalCCN 150101 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
15D0357666Parkview HLTH Labs at Whitley Hospital1260 E State Road 205, Columbia City, IN 46725AccreditationJan 2, 2027
15D1068085Parkview Whitley Hospital1260 E State Rd 205, Columbia City, IN 46725Certificate of waiverMay 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Whitley Memorial Hospital3 organizations share this tax ID, including this one
Part of
Whitley Memorial Hospital

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
James Heuer Individual Other Jan 1, 2015
Parkview Health System Inc Organization, Fort Wayne, IN 5% Or Greater Direct Ownership Interest Jun 28, 1995 100%
Cindy Baker Individual Other Jan 1, 2024
Jessica Lee-Hansen Individual Corporate Officer Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
Svetlana V Hagan Individual Other Jan 1, 2023
DJ Sigler Individual Other Jan 1, 2023
Torrey Bauer Individual Other Jan 1, 2024
Alan Grossnickle Individual Other Jan 1, 2024
David E Reinhard Individual Corporate Officer Jan 1, 2026
Richard Haddad Individual Other Jan 1, 2024
Robin Wright Individual Other Jan 1, 2024
Scott Gabriel Individual W-2 Managing EmployeeCoo Jun 27, 2010
Rick Henvey Individual Corporate OfficerCeo Jan 1, 2022
Christopher McKeand Individual Corporate Officer Jan 1, 2026
Angela Gakstatter-Tom Individual Other Jan 1, 2024
Scott Wiley Individual Corporate Officer Jan 1, 2026
Mark Johnson Individual Other Jan 1, 2023
Stanton Risser Individual Corporate Officer Jul 28, 2024
W-2 Managing Employee Jul 28, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 626

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 626

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1205844495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5600",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468955600",
            "telephone_number": "260-373-7008",
            "fax_number": "260-373-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E STATE ROAD 205",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "46725",
            "telephone_number": "260-248-9302",
            "fax_number": "260-248-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITLEY MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITLEY MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-08-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "LEE-HANSEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-388-0125",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "06-005090-1",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01300664",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP IDENTIFICATION #",
            "identifier": "4744",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM IDENTIFICATION #",
            "identifier": "000000098126",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPLAN IDENTIFICATION #",
            "identifier": "000000004969",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9422664",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304608369",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA COMP. ID#",
            "identifier": "000000098126",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404608378",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG ID#",
            "identifier": "03697300",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1509946",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100268830A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS IDENTIFICATION #",
            "identifier": "351965665-001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkview Whitley Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Parkview Whitley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia City, IN

Sources for this page

Verify at the official NPI Registry.