NPIMap

Organization Active NPI

Woodlawn Hospital

  • Nursing Facility/Intermediate Care Facility
  • Winona Lake, IN
National Provider Identifier
1285723734
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
060005011 Issued in IN
Legal business name
WOODLAWN HOSPITAL
Practice address
337 Grace Village Dr
Winona Lake, IN 46590-5774
Phone
(574) 372-6200
Fax
(574) 372-6386
NPI assigned
Oct 12, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
John Alley
Title
President/Ceo
Phone
(574) 223-3141

Owners & managing parties with NPI records 17

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

View all 17

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Corporate family (same tax ID) 25

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

View all 25

Facilities with the same owner 15

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

View all 15

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

Affiliated clinicians 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grace Village Health Care FacilityCCN 155635
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Aug 11, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7154.9 residents per day on average

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
15D0647418Dba Grace Village Health Care Facility Woodlawn337 Grace Village Dr, Winona Lake, IN 46590Certificate of waiverAug 31, 2026

Medicare participation

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

Skilled nursing facility certification: CCN 155635

Medicare enrollment files
Legal name
WOODLAWN HOSPITAL
Doing business as
GRACE VILLAGE HEALTH CARE FACILITY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 11, 1997
Last certification
Mar 24, 2025
Beds
153 (71 certified)
Ownership / control type
County
Multi-facility organization
Woodlawn Hospital
Most recent change of ownership
May 1, 2013
Organization structure
OtherNon-profit
Enrollment address
337 Grace Village Dr
Winona Lake, IN 46590-5774
Nursing home name
GRACE VILLAGE HEALTH CARE FACILITY

All disclosed owners & managing parties 16

Medicare enrollment files

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

NameRoleSinceShare
Alison M Heyde Individual Managing Control - Governing BodyBoard Member Sep 1, 2019
Trustee of the SNF Sep 9, 2019
Alan Jay Fisher Individual Operational/Managerial Control Jun 13, 2022
Terri L Johnson Individual Managing Control - Governing BodyBoard Member Jun 13, 2022
Trustee of the SNF Jun 13, 2022
Justin Kimbrell Individual Operational/Managerial Control Nov 1, 2013
Mark Schwob Individual Operational/Managerial Control Nov 1, 2013
Woodlawn Hospital Organization, Rochester, IN 5% Or Greater Direct Ownership Interest May 1, 2013 100%
Adp of the SNF May 28, 2025
Harry Webb Individual Managing Control - Governing BodyBoard Member Oct 15, 2023
Trustee of the SNF Oct 15, 2023
Andrew Offerle Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
David Koontz Individual Operational/Managerial Control Nov 1, 2013
Gregory Lee Mellinger Individual Managing Control - Governing BodyBoard Member Jun 13, 2022
Trustee of the SNF Jun 13, 2022
Glenn Hall Individual Operational/Managerial Control Nov 1, 2013
Jarod Williams Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
The Accounting Group LLC Organization, Evansville, IN LLC Adp of the SNF Jan 15, 2025
Glen W Bode Individual Trustee of the SNF Dec 9, 2022
Kendra Chudzynski Individual Trustee of the SNF Oct 15, 2024
Grace Village Health Care Facility, Inc. Organization, Winona Lake, IN Corporation Operational/Managerial Control May 1, 2013
Adp of the SNF Sep 14, 1978

All facility ownership & control disclosures 15

Medicare enrollment files

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

FacilityTypeRoleSince
Woodlawn HospitalRochester, IN, CCN 151313 Hospital Operational/Managerial Control Jan 8, 2010
Woodlawn HospitalRochester, IN, CCN 15Z313 Hospital Operational/Managerial Control Jan 8, 2010
Wesley Manor Health CenterFrankfort, IN, CCN 155658 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Apr 8, 2013
Mar 12, 2025
Timbercrest Church of the Brethren HomeNorth Manchester, IN, CCN 155740 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2014
Peabody Retirement CommunityNorth Manchester, IN, CCN 155655 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 31, 2014
Dec 17, 2025
Greencroft HealthcareGoshen, IN, CCN 155205 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Hamilton GroveNew Carlisle, IN, CCN 155672 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Nov 1, 2015
Dec 8, 2025
Southfield VillageSouth Bend, IN, CCN 155684 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Oak Grove Christian Retirement VillageDemotte, IN, CCN 155667 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Indirect Ownership Interest (100%)
Adp of the SNF		 Jan 1, 2016
Jan 1, 2016
Nov 17, 2025
Golden Years HomesteadFort Wayne, IN, CCN 155755 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2018
Woodlawn Medical ProfessionalsRochester, IN, CCN 158552 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Aug 1, 2013
Argos Medical CenterArgos, IN, CCN 158548 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Aug 1, 2013
Akron Medical CenterAkron, IN, CCN 158547 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Aug 1, 2013
Shafer Medical ClinicRochester, IN, CCN 158551 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Jan 1, 2012
Fulton County Medical ClinicRochester, IN, CCN 158550 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2012
Aug 1, 2013

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20130731000754 IN Part a Provider - Skilled Nursing Facility 4082506993 Practice locations: Winona Lake, IN

National Provider Directory

National Provider Directory
Tax ID family
Akron Medical (26 organizations share this tax ID)

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 060005011 IN
Nursing Facility/Intermediate Care Facility 313M00000X 060005011 IN Primary
Skilled Nursing Facility 314000000X 060005011 IN

Addresses

NPPES NPI Registry

Primary practice location

337 Grace Village Dr
Winona Lake, IN 46590-5774

Mailing address

337 Grace Village Dr
Winona Lake, IN 46590-5774
Phone (574) 372-6200

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
000000097895OtherINANTHEM PIN NUMBER
100266260AMedicaidIN
2297OtherINRBA HOME NUMBER

Other names 1

NPPES NPI Registry
  • Grace Village Health Care Facility Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 25, 2013.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1285723734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 GRACE VILLAGE DR",
            "city": "WINONA LAKE",
            "state": "IN",
            "postal_code": "465905774",
            "telephone_number": "574-372-6200",
            "fax_number": "574-372-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 GRACE VILLAGE DR",
            "city": "WINONA LAKE",
            "state": "IN",
            "postal_code": "465905774",
            "telephone_number": "574-372-6200",
            "fax_number": "574-372-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAWN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "ALLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "574-223-3141"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "060005011",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IN",
            "license": "060005011",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "060005011",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000097895",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100266260A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBA HOME NUMBER",
            "identifier": "2297",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Village Health Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winona Lake, IN

Sources for this page

Verify at the official NPI Registry.