Witham Memorial Hospital

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

070050931 Issued in IN

Legal business name

WITHAM MEMORIAL HOSPITAL

Doing business as

Witham Health Services

Practice address

2605 N Lebanon St
Lebanon, IN 46052-1476

Phone

(765) 485-8100

Fax

(765) 485-8118

NPI assigned

Feb 13, 2007

Last updated

Jul 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Braverman

Title

Ceo, President

Phone

(765) 485-8100

Specialties & licenses 1

Addresses

Other names 1

• Witham Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619019791. Details of each certification follow.

• CCN 15S104 Hospital · Details

Hospital certification: CCN 15S104

Legal name

WITHAM MEMORIAL HOSPITAL

Doing business as

WITHAM HEALTH SERVICES

Organization structure

OtherNon-profit

Enrollment address

2605 N Lebanon St
Lebanon, IN 46052-1476
Hospital Psychiatric Unit

Hospital subgroups

Psychiatric unit

Related certifications (CCN) 1

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

• Witham Memorial Hospital

  dba Witham Health Services

  • General Acute Care Hospital
  • Lebanon, IN
  • NPI 1699757401

  Unit of hospital

  Provider of Services

Tax ID family

Witham Health Services37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

• Hoosier Enterprises II, Inc.

  dba Especially Kidz Health & Rehab Center

  • Pediatric Skilled Nursing Facility
  • Shelbyville, IN
  • NPI 1801963053
  NPD tax ID
• Witham Memorial Hospital

  dba Grand Valley Health & Rehab

  • Skilled Nursing Facility
  • Martinsville, IN
  • NPI 1013926823
  NPD tax ID
• Witham Memorial Hospital

  dba The Villages at Historic Silvercrest

  • Skilled Nursing Facility
  • New Albany, IN
  • NPI 1124360367
  NPD tax ID
• Witham Memorial Hospital

  dba Wellbrooke of Wabash

  • Skilled Nursing Facility
  • Wabash, IN
  • NPI 1144564626
  NPD tax ID
• Witham Memorial Hospital

  dba St. Mary Healthcare Center

  • Skilled Nursing Facility
  • Lafayette, IN
  • NPI 1174768618
  NPD tax ID
• Witham Memorial Hospital

  dba Wellbrooke of Carmel

  • Skilled Nursing Facility
  • Carmel, IN
  • NPI 1194115386
  NPD tax ID
• Witham Memorial Hospital

  dba Greenleaf Health Campus

  • Skilled Nursing Facility
  • Elkhart, IN
  • NPI 1205153269
  NPD tax ID
• Witham Memorial Hospital

  dba Twin City Health Care

  • Skilled Nursing Facility
  • Gas City, IN
  • NPI 1235316142
  NPD tax ID
• Witham Memorial Hospital

  dba Alexandria Care Center

  • Skilled Nursing Facility
  • Alexandria, IN
  • NPI 1245399500
  NPD tax ID
• Witham Memorial Hospital

  dba Pineknoll Rehabilitation Centre

  • Skilled Nursing Facility
  • Winchester, IN
  • NPI 1275732950
  NPD tax ID
• Witham Memorial Hospital

  dba White Oak Health Campus

  • Skilled Nursing Facility
  • Monticello, IN
  • NPI 1306165915
  NPD tax ID
• Witham Memorial Hospital

  dba Westridge Health Care Center

  • Skilled Nursing Facility
  • Terre Haute, IN
  • NPI 1316061575
  NPD tax ID

All disclosed owners & managing parties 7

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

All facility ownership & control disclosures 32

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

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1619019791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8100",
            "fax_number": "765-485-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8100",
            "fax_number": "765-485-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "BRAVERMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "765-485-8100"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IN",
            "license": "070050931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Witham Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ted R Winkler, MD
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Boone County EMS)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital (Witham Health Services)
• Witham Memorial Hospital
• Witham Memorial Hospital (Homewood Health Campus)
• Witham Memorial Hospital (Pavilion Pointe Pharmacy)

• Psychiatric Hospital Unit in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Psychiatric Hospital Unit in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.