NPIMap

Organization Active NPI

Indiana University Health White Memorial Hospital Inc

Doing business as IU Health White Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Monticello, IN
National Provider Identifier
1316019722
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Doing business as
IU Health White Memorial Hospital
Practice address
720 S 6TH St
Monticello, IN 47960-8182
Phone
(574) 583-7111
Fax
(574) 583-1703
NPI assigned
Nov 14, 2006
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Mary Minier
Title
President
Phone
(574) 583-1757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

720 S 6TH St
Monticello, IN 47960-8182

Mailing address

950 N Meridian St Ste 1200
Indianapolis, IN 46204-1011
Phone (317) 962-1093

Other names 1

  • IU Health White Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110909002496 IN Part A Provider - Critical Access Hospital 5597934968 Practice locations: Monticello, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316019722. Details of each certification follow.

Hospital certification: CCN 15Z312

Legal name
INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Doing business as
IU HEALTH WHITE MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
720 S 6TH St
Monticello, IN 47960-8182
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Indiana University Health White Memorial Hospital Inc2 organizations share this tax ID, including this one
Part of
Indiana University Health White Memorial Hospital Inc

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Johnny Park Individual Corporate DirectorBoard of Directors Aug 2, 2023
Philip List Individual Corporate DirectorBoard of Director Jan 15, 2025
Liesel Delamater Individual Corporate Officer Aug 6, 2025
W-2 Managing Employee Aug 6, 2025
Operational/Managerial Control Aug 6, 2025
Indiana University Health Inc Organization, Indianapolis, IN Corporation, Non-profit Operational/Managerial Control Jul 1, 2011
Ying-Kei Hui Individual Corporate DirectorBoard of Directors Apr 3, 2024
Shan Sheridan Individual Corporate DirectorBoard of Directors Oct 4, 2017
Gary Henriott Individual Corporate DirectorBoard of Directors Jun 3, 2015
Erika J Ugianskis Individual Corporate DirectorBoard of Director Aug 4, 2021
William Li Individual Corporate DirectorBoard of Director Aug 1, 2019
Whitney Aiken Individual Corporate OfficerLegal Counsel / Secretary Sep 1, 2024
Umesh Patel Individual Corporate DirectorBoard of Directors Oct 5, 2022
Arthur Vasquez Individual Corporate OfficerPresident Jun 7, 2021
Ruban Nirmalan Individual Corporate DirectorBoard of Directors Jun 1, 2014
Mark a Buono Individual Corporate DirectorBoard Member Dec 1, 2021
Benjamin Harpenau Individual Corporate DirectorBoard of Directors Aug 2, 2023
Michael Craig Individual Corporate OfficerCfo Jul 1, 2024

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 18

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

View all 18

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1316019722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N MERIDIAN ST STE 1200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041011",
            "telephone_number": "317-962-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S 6TH ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479608182",
            "telephone_number": "574-583-7111",
            "fax_number": "574-583-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "MINIER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-583-1757"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health White Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, IN

Sources for this page

Verify at the official NPI Registry.