Pulaski Memorial Hospital
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Winamac, IN
NPI 1447467196 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1447467196
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- 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
- May 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Gregg A Malott
- Title
- CF0
- Phone
- (574) 946-2100
Owners & managing parties with NPI records 2
-
Charles Randall Hutton, D.D.S.
Corporate family (same tax ID) 42
Related certifications (CCN) 1
Affiliated clinicians 3
-
Timothy Day, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Hospital certification: CCN 15Z305
- Legal name
- PULASKI MEMORIAL HOSPITAL
- Doing business as
- PULASKI MEMORIAL HOSPITAL
- Organization structure
- Other · Non-profit
- Enrollment address
- 616 E 13TH St
# 279
Winamac, IN 46996-1117
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Linda Webb |
Corporate Officer |
Apr 2, 1995 | |
| W-2 Managing Employee |
Apr 2, 1995 | ||
| Gregg a Malott |
Corporate Officer |
Oct 10, 2014 | |
| W-2 Managing Employee |
Apr 9, 2007 | ||
| Michael McKay |
Corporate Director |
Jul 1, 2022 | 14.29% |
| Jennifer Smith |
Corporate Director |
Feb 22, 2022 | 14.29% |
| Adam Bennett |
Corporate Director |
Jan 1, 2022 | 14.29% |
| Stephen Jarosinski |
Corporate Officer |
Jan 1, 2022 | |
| Taylor White |
Corporate Officer |
Nov 1, 2022 | 14.29% |
| Clinton Kauffman |
Corporate Director |
Aug 1, 2019 | 14.29% |
| Charles R Hutton |
Corporate Director |
Aug 27, 2014 | 14.29% |
| Jennifer Mellon |
Operational/Managerial Control |
Oct 29, 2024 | 14.29% |
All facility ownership & control disclosures 28
| Facility | Type | Role | Since |
|---|---|---|---|
| Envive of River City |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2014 Jul 1, 2014 |
| Majestic Care of West Allen |
Skilled nursing facility | Operational/Managerial Control (100%) | Jun 1, 2015 |
| Parkview Haven |
Skilled nursing facility | Operational/Managerial Control (100%) | Sep 1, 2015 |
| Kingston Health Center of Fort Wayne |
Skilled nursing facility | Operational/Managerial Control (100%) | Dec 16, 2025 |
| Northern Lakes Nursing and Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control (100%) | Oct 1, 2015 |
| The Milton Home |
Skilled nursing facility | Operational/Managerial Control (100%) | Dec 1, 2016 |
| Simmons Loving Care Health Facility |
Skilled nursing facility | Operational/Managerial Control (100%) | May 1, 2018 |
| Maple Manor Christian Home |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2019 |
| Saint Anthony |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2020 |
| Majestic Care of Jefferson Pointe |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 31, 2020 |
| Majestic Care of Avon |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Dec 31, 2020 |
| Cardinal Care Strategies |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 27, 2021 |
| Majestic Care of Carmel |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2021 |
| Majestic Care of Southport |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2021 |
| Poplar Care Strategies |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Sycamore Care Strategies |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2022 |
| Gentle Care Strategies |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2022 |
| Heritage Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2023 |
| Saint Anthony |
Skilled nursing facility | Operational/Managerial Control (100%) | Apr 1, 2023 |
| Hickory Creek at Rochester |
Skilled nursing facility | Operational/Managerial Control (100%) | Apr 1, 2023 |
| Briarcliff Health & Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control (100%) | Jan 1, 2024 |
| South Shore Health & Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control (100%) | Jan 1, 2024 |
| Asbury Towers Health Care Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jul 1, 2024 Jul 1, 2024 |
| Pulaski Memorial Hospital |
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 Medicine |
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 Medicine |
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 Center |
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 Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2024 Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071214000399 | IN | Part a Provider - Critical Access Hospital | 3173515509 | Practice locations: Winamac, IN |
National Provider Directory
- Tax ID family
- Cindy Parker MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Yes |
Addresses
Primary practice location
616 E 13TH St
Winamac, IN 46996-1117
Mailing address
PO Box 279
616 E 13TH Street
Winamac, IN 46996-0279
Phone (574) 946-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000097769 | Other | IN | ANTHEM |
Other providers in Winamac, IN
- Pulaski County Auditor
- Pulaski County Health Department
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
All providers in Winamac, IN · Medicare Defined Swing Bed Hospital Unit in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.