Active NPI
Adams County Memorial Hospital
Doing business as Envive of Beech Grove
- Skilled Nursing Facility
- Beech Grove, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ADAMS COUNTY MEMORIAL HOSPITAL
- Doing business as
- Envive of Beech Grove
- Practice address
- 501 N 17TH Ave
Beech Grove, IN 46107-1169 - Phone
- (317) 786-2261
- NPI assigned
- Sep 26, 2022
- Last updated
- Oct 17, 2026
- 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
- Kyle Sprunger
- Title
- Cfo/Treasurer
- Phone
- (260) 724-2145
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
501 N 17TH Ave
Beech Grove, IN 46107-1169
Mailing address
1100 Mercer Ave
Decatur, IN 46733-2303
Other names 1
- Envive of Beech Grove
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221020000825 | IN | Part A Provider - Skilled Nursing Facility | 0941198253 | Practice locations: Beech Grove, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1417670324. Details of each certification follow.
Skilled nursing facility certification: CCN 155859
- Legal name
- ADAMS COUNTY MEMORIAL HOSPITAL
- Doing business as
- ENVIVE OF BEECH GROVE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 20, 2022
- Last certification
- Dec 18, 2024
- Beds
- 109 (52 certified)
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Envive of Healthcare
- Organization structure
- Government
- Enrollment address
- 501 N 17TH Ave
Beech Grove, IN 46107-1169 - Nursing home name
- ENVIVE OF BEECH GROVE
- Affiliated entity
- ENVIVE HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Envive of Beech Grove
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 20, 2022
- Medicare certification status
- Active
- Certified beds
- 52
- Chain
- Envive Healthcare
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 |
|---|---|---|---|
| 15D0352569 | Envive of Beech Grove | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Adams Co Memorial Hospi
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Manderley Health Care Center
- Skilled Nursing Facility
- Osgood, IN
- NPI 1366440927
-
dba River Terrace Health Care Center
- Skilled Nursing Facility
- Bluffton, IN
- NPI 1366531907
-
dba Decatur Family Medicine
- Rural Health Clinic/Center
- Decatur, IN
- NPI 1376043752
-
dba Northwest Manor Health Care Center
- Skilled Nursing Facility
- Indianapolis, IN
- NPI 1376531681
-
dba Adams Medical Group - Berne
- Rural Health Clinic/Center
- Berne, IN
- NPI 1386269421
-
dba Sacred Heart Village
- Skilled Nursing Facility
- Avilla, IN
- NPI 1386630416
-
dba Envive of Anderson
- Skilled Nursing Facility
- Anderson, IN
- NPI 1386661320
-
dba Brookville Healthcare Center
- Skilled Nursing Facility
- Brookville, IN
- NPI 1386735421
-
dba Partners In Care
- Oxygen Equipment & Supplies (DME)
- Decatur, IN
- NPI 1396871299
-
dba Waldron Health and Rehab Center
- Skilled Nursing Facility
- Waldron, IN
- NPI 1407847361
-
dba Colonial Nursing Home
- Skilled Nursing Facility
- Crown Point, IN
- NPI 1407959059
-
dba Adams Medical Group - High Street
- Rural Health Clinic/Center
- Decatur, IN
- NPI 1427516103
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.
| Name | Role | Since | Share |
|---|---|---|---|
| David Benson | Operational/Managerial Control | Oct 24, 2022 | |
| Adp of the SNF | Oct 24, 2022 | ||
| First Bank of Berne | Adp of the SNF | Oct 1, 2022 | |
| Marwan Mustaklem | Operational/Managerial Control | Dec 12, 2022 | |
| Adp of the SNF | Dec 12, 2022 | ||
| Adams County Memorial Hospital | Direct Ownership Interest | Oct 1, 2022 | 100% |
| Envive Healthcare LLC | Adp of the SNF | Oct 1, 2022 | |
| Scott E Lehman | Operational/Managerial Control | Oct 1, 2022 | |
| Managing Control - Governing Body | Oct 1, 2022 | ||
| 501 N 17TH Property LLC | Adp of the SNF | Oct 1, 2022 | |
| Bankwell Bank | 5% Or Greater Mortgage Interest | Oct 1, 2022 | 100% |
| Larry Macklin | Operational/Managerial Control | Oct 1, 2022 | |
| Managing Control - Governing Body | Oct 1, 2022 | ||
| LT Care Acquisition Corp | Operational/Managerial Control | Oct 1, 2022 | |
| Adp of the SNF | Oct 1, 2022 | ||
| Paul Hermitage Operator LLC | Operational/Managerial Control | Oct 1, 2022 | |
| Adp of the SNF | Oct 1, 2022 | ||
| Dane Wheeler | Corporate Officer | Oct 1, 2022 | 100% |
| Operational/Managerial Control | Oct 1, 2022 | ||
| Russell W Flueckiger | Operational/Managerial Control | Oct 1, 2022 | |
| Managing Control - Governing Body | Oct 1, 2022 | ||
| David McIntire | Managing Control - Governing Body | Oct 1, 2022 | |
| Candice Borne-Bauman | Operational/Managerial Control | Oct 1, 2022 | |
| Managing Control - Governing Body | Oct 1, 2022 | ||
| Blue Management Services LLC | Adp of the SNF | Jan 1, 2024 | |
| Kyle Sprunger | Corporate Officer | Oct 1, 2022 | 100% |
| Operational/Managerial Control | Oct 1, 2022 | ||
| Scott T Smith | Corporate Officer | Oct 1, 2022 | 100% |
| Operational/Managerial Control | Oct 1, 2022 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Optometrist
- Berne, IN
- NPI 1619977113
Managing Control - Governing Body, Operational/Managerial Control
-
- Internal Medicine Physician
- Fishers, IN
- NPI 1750357513
Adp of the SNF, Operational/Managerial Control
All facility ownership & control disclosures 59
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Adams County Memorial Hospital | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Adams County Memorial Hospital | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Adams Woodcrest | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Nov 22, 2005 Nov 22, 2005 Nov 22, 2005 |
| Adams Heritage | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Apr 28, 2004 Apr 28, 2004 Apr 28, 2004 |
| Woodland Manor | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
May 1, 2012 May 1, 2012 |
| Warsaw Meadows | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Colonial Nursing Home | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2012 Jun 1, 2012 |
| Lutheran Life Villages | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Hawthorne Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Lutheran Life Villages | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Kendallville Manor | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2012 Oct 1, 2012 |
| Northwest Manor Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Cloverleaf of Knightsville | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2012 Jul 1, 2012 |
| Majestic Care of Goshen | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Feb 19, 2013 Feb 19, 2013 |
| Caroleton Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2013 May 1, 2013 |
| Christian Care Retirement Community | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2013 Jan 1, 2025 |
| Cathedral Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 1, 2014 Nov 1, 2014 |
| River Terrance Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2014 |
| Lutheran Life Villages | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| The Cedars | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2015 Jun 1, 2015 |
| Chesterton Manor | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Aug 1, 2015 Aug 1, 2015 |
| Yorktown Manor | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Aug 1, 2015 Aug 1, 2015 |
| Sacred Heart Village | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2015 |
| Majestic Care of New Haven | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 1, 2015 Nov 1, 2015 |
| Chalet Rehabilitation and Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 1, 2015 Jul 1, 2013 |
| Silver Memories Health Care | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Oct 1, 2015 Oct 1, 2015 |
| Saint Anne Home | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Sep 1, 2016 Sep 1, 2016 |
| Holy Cross Rehabilitation and Wellness | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Aug 1, 2017 |
| Swiss Village | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2018 |
| Oak Village | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2017 Dec 1, 2017 |
| Shady Nook Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Sep 1, 2020 Sep 1, 2020 |
| Envive of Lawrenceburg | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2021 Dec 1, 2021 |
| The Waters of Georgetown | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Envive of Berne | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2021 Dec 1, 2021 |
| Envive of Huntington | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2021 |
| Envive of Anderson | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2021 |
| Envive of Indianapolis | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2021 |
| Envive of Hartford City | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Envive of Sullivan | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Heritage Pointe of Huntington | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2022 Jun 1, 2022 |
| Heritage Pointe of Warren | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2022 Jun 1, 2022 |
| Heritage Pointe of Fort Wayne | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2022 Jun 1, 2022 |
| River Bend Nursing and Rehbilitation | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Sep 1, 2022 Sep 1, 2022 |
| Manderley Health Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2022 Dec 1, 2022 |
| Envive of Evansville | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2023 Jul 1, 2023 |
| Harrison Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2023 Dec 1, 2023 |
| Rolling Hills Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2023 Dec 1, 2023 |
| Sellersburg Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2023 Dec 1, 2023 |
| Wedgewood Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Dec 1, 2023 Dec 1, 2023 Dec 31, 2025 |
| Indian Creek Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2023 Dec 1, 2023 |
| Chase Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2024 |
| Pilgrim Manor | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jul 1, 2024 Jan 1, 2025 |
| Envive of Muncie | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jan 1, 2025 Jan 1, 2025 |
| Envive of Liberty | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jan 1, 2025 Jan 1, 2025 |
| Monroe Family Medicine | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Adams Statcare and Behavioral Health | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2017 |
| Decatur Family Medicine - Woodcrest Connection | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2017 |
| Adams Medical Group - High Street | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2019 |
| Adams Medical Group - Geneva | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2025 |
Facilities with the same owner 16
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Chalet Rehabilitation and Healthcare Center
- Skilled Nursing Facility
- Indianapolis, IN
- NPI 1144253451
LT Care Acquisition Corp
-
dba Envive of Huntington
- Skilled Nursing Facility
- Huntington, IN
- NPI 1235315425
LT Care Acquisition Corp
-
dba Envive of Anderson
- Skilled Nursing Facility
- Anderson, IN
- NPI 1386661320
LT Care Acquisition Corp
-
dba Waldron Health and Rehab Center
- Skilled Nursing Facility
- Waldron, IN
- NPI 1407847361
LT Care Acquisition Corp
-
dba Envive of Indianapolis
- Skilled Nursing Facility
- Indianapolis, IN
- NPI 1477626026
LT Care Acquisition Corp
-
dba Chateau Rehabilitation and Healthcare Center
- Skilled Nursing Facility
- Fort Wayne, IN
- NPI 1518308295
LT Care Acquisition Corp
-
dba Envive of Muncie
- Skilled Nursing Facility
- Muncie, IN
- NPI 1609981372
LT Care Acquisition Corp
-
dba Envive of Liberty
- Skilled Nursing Facility
- Liberty, IN
- NPI 1619176641
LT Care Acquisition Corp
-
dba Envive of Evansville
- Skilled Nursing Facility
- Evansville, IN
- NPI 1730177551
LT Care Acquisition Corp
-
dba Envive of Berne
- Skilled Nursing Facility
- Berne, IN
- NPI 1730256991
LT Care Acquisition Corp
-
dba Envive of Lawrenceburg
- Skilled Nursing Facility
- Lawrenceburg, IN
- NPI 1902920069
LT Care Acquisition Corp
-
dba Envive of Hartford City
- Skilled Nursing Facility
- Hartford City, IN
- NPI 1922206952
LT Care Acquisition Corp
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792195200000",
"number": "1417670324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 MERCER AVE",
"city": "DECATUR",
"state": "IN",
"postal_code": "467332303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N 17TH AVE",
"city": "BEECH GROVE",
"state": "IN",
"postal_code": "461071169",
"telephone_number": "317-786-2261"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADAMS COUNTY MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-26",
"last_updated": "2026-10-17",
"certification_date": "2026-10-17",
"status": "A",
"authorized_official_last_name": "SPRUNGER",
"authorized_official_first_name": "KYLE",
"authorized_official_title_or_position": "CFO/TREASURER",
"authorized_official_telephone_number": "260-724-2145"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Envive of Beech Grove",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Beech Grove, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2026; 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.