NPIMap

Organization Active NPI

Witham Memorial Hospital

Doing business as McGivney Health Care Center

  • Skilled Nursing Facility
  • Carmel, IN
National Provider Identifier
1629066790
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
04-000545-1 Issued in IN
Legal business name
WITHAM MEMORIAL HOSPITAL
Doing business as
McGivney Health Care Center
Practice address
2907 E 136TH St
Carmel, IN 46033-9402
Phone
(317) 846-0265
Fax
(317) 846-3944
NPI assigned
Oct 12, 2005
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 04-000545-1 IN Primary

Addresses

Primary practice location

2907 E 136TH St
Carmel, IN 46033-9402

Mailing address

6401 S US Highway 41
Terre Haute, IN 47802-4749
Phone (812) 298-3002

Other identifiers 1

IdentifierTypeStateIssuer
100267350MedicaidIN

Other names 1

  • McGivney Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170315001837 IN Part A Provider - Skilled Nursing Facility 4082523170 Practice locations: Carmel, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629066790. Details of each certification follow.

Skilled nursing facility certification: CCN 155855

Legal name
WITHAM MEMORIAL HOSPITAL
Doing business as
MCGIVNEY HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 16, 2017
Last certification
Oct 2, 2024
Beds
37
Ownership / control type
Nonprofit Corporation
Organization structure
OtherNon-profit
Enrollment address
2907 E Smoky Row
Carmel, IN 46033-9402
Nursing home name
MCGIVNEY HEALTH CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
McGivney Health Care CenterCCN 155855 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 16, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3734.1 residents per day on average
Penalties (3 years)
2Fines totaling $8,189

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0950843McGivney Health Care Center2907 East Smoky Row, Carmel, IN 46033Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
James Anthony Boudreau37 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.

View all 36

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Julie Reagan Individual Corporate DirectorBoard Trustee Feb 21, 2025
Kelly Braverman Individual Corporate OfficerCeo, President Dec 1, 2021 100%
Randall Shera Individual Operational/Managerial ControlMHCC Administrator Apr 2, 2018
Adp of the SNF Dec 8, 2025
Witham Memorial Hospital Organization, Lebanon, IN 5% Or Greater Direct Ownership Interest Apr 1, 2015 100%
Daniel E Sellers Individual Corporate OfficerSVP-Cfo Jun 24, 2024
Fred Schmits Individual Corporate DirectorBoard Member of Gibault Care, Inc. Jul 1, 2015
John Compton Individual Corporate DirectorBoard Member of Gibault Care, Inc. Jul 1, 2015
Michael Jason Hornbecker Individual Corporate DirectorBoard Trustee Jan 1, 2024
Deborah Emminger Individual Corporate OfficerBoard Vice-Chair of Gibault Care Jul 1, 2024
Andrea Castetter Individual Corporate DirectorBoard Trustee Jan 1, 2023
Joe Banks Individual Operational/Managerial Control Jun 27, 2024
Adp of the SNF Dec 8, 2025
James W Funk Individual Corporate DirectorBoard Chair of Gibault Care, Inc. Jul 1, 2011
Claude a Hawkins Individual Corporate DirectorBoard Trustee Sep 1, 2013
John W Brand Individual Corporate DirectorBoard Trustee Jan 1, 2015
Brett Bayston Individual Corporate DirectorBoard Trustee Jan 1, 2023
Gibault Care, Inc. Organization, Terre Haute, IN Non-profit Operational/Managerial Control Apr 1, 2015 100%
Lori Patrick Individual Corporate DirectorBoard Member of Gibault Care, Inc. Jul 1, 2022

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 31

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

FacilityTypeRoleSince
Witham Health ServicesLebanon, IN, CCN 150104 Hospital Operational/Managerial Control (100%) Nov 24, 2011
Ambassador HealthcareCenterville, IN, CCN 155490 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2011
Vermillion Convalescent CenterClinton, IN, CCN 155124 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Twin City HealthcareGas City, IN, CCN 155232 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Westridge Health Care CenterTerre Haute, IN, CCN 155234 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Persimmon Ridge Rehabilitation CentrePortland, IN, CCN 155526 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Grand Valley Health & RehabMartinsville, IN, CCN 155605 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Willow Crossing Health & Rehabilitation CenterColumbus, IN, CCN 155535 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2011
Pineknoll Rehabilitation CentreWinchester, IN, CCN 155527 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2011
Camelot Care CenterLogansport, IN, CCN 155385 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2012
Alexandria Care CenterAlexandria, IN, CCN 155521 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2012
White Oak Health CampusMonticello, IN, CCN 155782 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
St Mary Healthcare CenterLafayette, IN, CCN 155094 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Waterford Place Health CampusKokomo, IN, CCN 155678 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Cumberland Pointe Health CampusWest Lafayette, IN, CCN 155775 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Blair Ridge Health CampusPeru, IN, CCN 155791 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Woodbridge Health CampusLogansport, IN, CCN 155724 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Greenleaf Health CampusElkhart, IN, CCN 155783 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
St Elizabeth Healthcare CenterDelphi, IN, CCN 155290 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Homewood Health CampusLebanon, IN, CCN 155680 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Arlington Place Health CampusIndianapolis, IN, CCN 155816 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Wellbrooke of WabashWabash, IN, CCN 155806 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Wellbrooke of KokomoKokomo, IN, CCN 155819 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
The Villages at Historic SilvercrestNew Albany, IN, CCN 155813 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
The Springs at LafayetteLafayette, IN, CCN 155829 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Wellbrooke of CarmelCarmel, IN, CCN 155833 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Clearvista Lake Health CampusIndianapolis, IN, CCN 155815 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Brooke Knoll VillageAvon, IN, CCN 155814 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
Westminster Village KentuckianaClarksville, IN, CCN 155191 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2023
Suburban Home Health, LLCNoblesville, IN, CCN 157092 Home health agency 5% Or Greater Indirect Ownership Interest (10.27%) Sep 3, 2024
Suburban HospiceNoblesville, IN, CCN 151547 Hospice 5% Or Greater Indirect Ownership Interest (10.27%) Nov 1, 2024

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1629066790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 S US HIGHWAY 41",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024749",
            "telephone_number": "812-298-3002",
            "fax_number": "812-298-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 E 136TH ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339402",
            "telephone_number": "317-846-0265",
            "fax_number": "317-846-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "04-000545-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100267350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McGivney Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McGivney Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.