NPIMap

Organization Active NPI

Pulaski Memorial Hospital

  • Critical Access Hospital
  • Winamac, IN
National Provider Identifier
1306928213
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
060050841 Issued in IN
Legal business name
PULASKI MEMORIAL HOSPITAL
Practice address
616 E 13TH St
Winamac, IN 46996-1117
Phone
(574) 946-2100
Fax
(574) 946-2129
NPI assigned
Oct 19, 2006
Last updated
Mar 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Gregg Malott
Title
VP of Business Development
Phone
(574) 946-2103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 060050841 IN Primary

Addresses

Primary practice location

616 E 13TH St
Winamac, IN 46996-1117

Mailing address

616 E 13TH St
PO Box 279
Winamac, IN 46996-1117
Phone (574) 946-2100

Other identifiers 1

IdentifierTypeStateIssuer
100270350MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071214000021 IN Part A Provider - Critical Access Hospital 3173515509 Receives reassigned benefits from 49 practitioners
Practice locations: Winamac, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306928213. Details of each certification follow.

Hospital certification: CCN 151305

Legal name
PULASKI MEMORIAL HOSPITAL
Doing business as
PULASKI MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2000
Last certification
Oct 18, 2017
Beds
25
Ownership / control type
Other
Organization structure
OtherNon-profit
Incorporated
Aug 3, 1959 in IN
Enrollment address
616 E 13TH St
Winamac, IN 46996-1117

Facilities connected through Provider of Services related, parent or unit certification numbers.

Care Compare: Hospital

Medicare Care Compare
Listed as
Pulaski Memorial HospitalCCN 151305 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Michael D Ramone DO43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

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
Alliance Bank Organization, Winamac, IN Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Feb 22, 2012 14.2%
Marilyn Newman Individual Corporate DirectorBoard of Trustees Oct 30, 2018 14.29%
Linda Webb Individual Corporate OfficerChief Nursing Executive Apr 2, 1995
Gregg a Malott Individual Corporate OfficerCfo Apr 9, 2007
W-2 Managing EmployeeCfo Apr 9, 2007
Michael McKay Individual Corporate DirectorBoard of Trustees Jul 1, 2022 14.29%
Jennifer Smith Individual Corporate DirectorBoard of Trustees Feb 22, 2022 14.29%
Adam Bennett Individual Corporate DirectorBoard of Trustees Jan 1, 2022 14.29%
Stephen Jarosinski Individual Corporate OfficerCeo Jan 1, 2022
Clinton Kauffman Individual Corporate DirectorBoard of Trustees Aug 1, 2019 14.29%
Charles R Hutton Individual Corporate DirectorBoard of Trustees Member Aug 27, 2002 14.29%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 28

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

FacilityTypeRoleSince
Envive of River CityEvansville, IN, CCN 155520 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2014
Jul 1, 2014
Majestic Care of West AllenFort Wayne, IN, CCN 155322 Skilled nursing facility Operational/Managerial Control (100%) Jun 1, 2015
Parkview HavenFrancesville, IN, CCN 155746 Skilled nursing facility Operational/Managerial Control (100%) Sep 1, 2015
Kingston Health Center of Fort WayneFort Wayne, IN, CCN 155479 Skilled nursing facility Operational/Managerial Control (100%) Dec 16, 2025
Northern Lakes Nursing and Rehabilitation CenterAngola, IN, CCN 155449 Skilled nursing facility Operational/Managerial Control (100%) Oct 1, 2015
The Milton HomeSouth Bend, IN, CCN 155738 Skilled nursing facility Operational/Managerial Control (100%) Dec 1, 2016
Simmons Loving Care Health FacilityGary, IN, CCN 155845 Skilled nursing facility Operational/Managerial Control (100%) May 1, 2018
Maple Manor Christian HomeSellersburg, IN, CCN 155766 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2019
Saint AnthonyCrown Point, IN, CCN 155214 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2020
Majestic Care of Jefferson PointeFort Wayne, IN, CCN 155446 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2020
Majestic Care of AvonAvon, IN, CCN 155338 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2020
Cardinal Care StrategiesMuncie, IN, CCN 155400 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 27, 2021
Majestic Care of CarmelCarmel, IN, CCN 155618 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2021
Majestic Care of SouthportIndianapolis, IN, CCN 155247 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2021
Poplar Care StrategiesLoogootee, IN, CCN 155374 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Sycamore Care StrategiesLoogootee, IN, CCN 155263 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Gentle Care StrategiesVincennes, IN, CCN 155519 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Heritage CenterEvansville, IN, CCN 155104 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
Saint AnthonyWinamac, IN, CCN 155436 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2023
Hickory Creek at RochesterRochester, IN, CCN 155430 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2023
Briarcliff Health & Rehabilitation CenterSouth Bend, IN, CCN 155831 Skilled nursing facility Operational/Managerial Control (100%) Jan 1, 2024
South Shore Health & Rehabilitation CenterGary, IN, CCN 155530 Skilled nursing facility Operational/Managerial Control (100%) Jan 1, 2024
Asbury Towers Health Care CenterGreencastle, IN, CCN 155758 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2024
Jul 1, 2024
Pulaski Memorial HospitalWinamac, IN, CCN 158512 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 2002
Mar 20, 2002
Pulaski Memorial Hospital Francesville Family MedicineFrancesville, IN, CCN 158528 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1989
Jan 1, 1989
Pulaski Memorial Hospital North Judson Family MedicineNorth Judson, IN, CCN 158527 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1989
Jan 1, 1989
Pulaski Memorial Hospital Knox Medical CenterKnox, IN, CCN 158554 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 1, 2019
Sep 1, 2019
Pulaski Memorial Hospital Culver Medical CenterCulver, IN, CCN 158581 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2024
Jan 1, 2024

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

Affiliated clinicians 89

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

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1306928213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E 13TH ST",
            "address_2": "PO BOX 279",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469961117",
            "telephone_number": "574-946-2100",
            "fax_number": "574-946-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E 13TH ST",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469961117",
            "telephone_number": "574-946-2100",
            "fax_number": "574-946-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "MALOTT",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "VP OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "574-946-2103"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IN",
            "license": "060050841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winamac, IN

Sources for this page

Verify at the official NPI Registry.