Westminster Village West Lafayette, Inc
Organization Active NPI Skilled Nursing Facility · West Lafayette, IN
NPI 1497740633 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1497740633
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 050000931 (IN)
- Legal business name
- WESTMINSTER VILLAGE WEST LAFAYETTE, INC
- Practice address
- 2741 N Salisbury St
West Lafayette, IN 47906-1431 - Phone
- (765) 463-7546
- Fax
- (765) 463-6846
- NPI assigned
- Sep 14, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Judy Bane
- Title
- Health Care Administrator
- Phone
- (765) 463-7546
Owners & managing parties with NPI records 4
-
Keven W. Dodt, M.D.
-
William Y Li, MD
Facilities with the same owner 57
Affiliated clinicians 14
-
Zarah-Ann A Alba, M.D.
-
Keven W. Dodt, M.D.
-
Joel R Mulder, DO
-
Carlos Salazar Carcamo, M.D.
-
Peter Andrew Seymour, PETER SEYMOUR D.O.
-
Ramya Vadlamudi, M.D
-
Evyan Jawad, MB,CHB
Medicare Care Compare: Nursing home
- Listed as
- Westminster Village - West Lafayette
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Feb 1, 1979
- Medicare certification status
- Active
- Certified beds
- 72 · 64.8 residents per day on average
- Chain
- Life Care Services
- Penalties (3 years)
- 1 · fines totaling $72,545
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Skilled nursing facility certification: CCN 155177
- Legal name
- WESTMINSTER VILLAGE WEST LAFAYETTE, INC
- Doing business as
- WESTMINSTER VILLAGE WEST LAFAYETTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 1, 1979
- Last certification
- Feb 25, 2025
- Beds
- 184 (72 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2741 N Salisbury St
West Lafayette, IN 47906-1431 - Nursing home name
- WESTMINSTER VILLAGE - WEST LAFAYETTE
- Affiliated entity
- LIFE CARE SERVICES
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Branch Banking & Trust Company |
5% Or Greater Mortgage Interest | Jun 21, 2021 | 31% |
| Benjamin J Blankenship |
Operational/Managerial Control |
Jan 18, 2019 | |
| Anna M. Wilson |
Corporate Officer |
Jul 1, 2022 | |
| Don Gentry |
Corporate Director |
Dec 1, 2021 | |
| Agnes Sullivan |
Corporate Officer |
Jul 1, 2023 | |
| Marianne Rose |
Corporate Officer |
Aug 1, 2020 | |
| Corporate Director |
Aug 1, 2020 | ||
| Jane a Smith |
Corporate Officer |
Jul 1, 2020 | |
| Corporate Director |
Jul 13, 2018 | ||
| John M Thomas |
Operational/Managerial Control | Dec 8, 2022 | |
| Adp of the SNF | May 15, 2025 | ||
| William Li |
Operational/Managerial Control | Dec 8, 2022 | |
| Adp of the SNF | May 12, 2025 | ||
| Life Care Services LLC |
Operational/Managerial Control | Jan 1, 2021 | |
| Adp of the SNF | Apr 21, 2025 | ||
| Marcella M Tashjian Gibbs |
Corporate Officer |
Jul 1, 2023 | |
| Stephanie Long |
Corporate Officer |
Jul 1, 2023 | |
| Kristin Patz |
Operational/Managerial Control | Feb 24, 2025 | |
| Adp of the SNF | May 12, 2025 | ||
| Brad L Deno |
Corporate Officer |
Jul 1, 2016 | |
| Corporate Director |
Jul 1, 2016 | ||
| Keven W Dodt |
Operational/Managerial Control | Dec 8, 2022 | |
| Adp of the SNF | May 12, 2025 | ||
| Westminster Village West Lafayette, Inc |
5% Or Greater Direct Ownership Interest | Dec 23, 2011 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110222000941 | IN | Part a Provider - Skilled Nursing Facility | 9537065743 | Practice locations: West Lafayette, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 050000931 | IN | Yes |
Addresses
Primary practice location
2741 N Salisbury St
West Lafayette, IN 47906-1431
Mailing address
2741 N Salisbury St
West Lafayette, IN 47906-1431
Phone (765) 463-7546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000230877 | Other | IN | BLUE CROSS PROVIDER # |
Other providers in West Lafayette, IN
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- West Lafayette Community School Corporation
- West Side Rehabilitation Inc
- Kayla West
- Karen Elaine Westfall Collier
- Jason Douglas Wethington
- Dawn Elizabeth Wetzel
- Johnetta Whitmire
- Amanda Brooke Wichert
- Rachel Wichlinski
All providers in West Lafayette, IN · Skilled Nursing Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.