Decatur County Memorial Hospital
Organization Active NPI Skilled Nursing Facility · Whitestown, IN
NPI 1629698808 · NPPES record last updated Apr 17, 2020
Key facts
- NPI
- 1629698808
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- DECATUR COUNTY MEMORIAL HOSPITAL
- Practice address
- 6712 Restoracy Drive
Whitestown, IN 46075-0089 - Phone
- (317) 769-8888
- NPI assigned
- Apr 17, 2020
- Organization subpart
- No
Authorized official
- Name
- Ms. Catherine Elizabeth Keck
- Title
- Chief Financial Officer
- Phone
- (812) 669-4331
Owners & managing parties with NPI records 9
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 19
Facilities with the same owner 5
Practitioners 128
-
Shakeeb Syed Ahmad, M.D.
-
Arthur P Alunday, MD
-
Anwar Chucky Ashraf, M.D.
-
Kenaz Bakdash, MD
-
Marcella Dawn Baumer, PA-C
-
James J Blahunka, MD
-
James R Bognanno, M.D.
-
Michael Boulous, MD
-
Justin P. Chang, M.D.
-
Jason Wayne Christie, M.D.
-
Jamie L Cooper, DO
-
Matthew T Dewitt, DPM
-
Erin Elizabeth Diem, FNP
-
Timothy D Divens, MD
-
Naveed A Fazlani, M.D., MBA
-
Michael D Fisher, MD
-
Jennifer L. Fletcher, M.D.
-
Luke Flood, MD
Affiliated clinicians 3
Medicare Care Compare: Nursing home
- Listed as
- Restoracy of Whitestown, the
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 2020
- Medicare certification status
- Active
- Certified beds
- 72 · 68.3 residents per day on average
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2181997 | Restoracy of Whitestown, the | Certificate of waiver | Apr 13, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Skilled nursing facility certification: CCN 155858
- Legal name
- DECATUR COUNTY MEMORIAL HOSPITAL
- Doing business as
- THE RESTORACY OF WHITESTOWN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 2020
- Last certification
- Dec 19, 2024
- Beds
- 72
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- The Restoracy
- Organization structure
- Government · Non-profit
- Enrollment address
- 6712 Restoracy Dr
Whitestown, IN 46075-0089 - Nursing home name
- RESTORACY OF WHITESTOWN, THE
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Leo M Solito |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jun 17, 2025 | ||
| Euson Lindsey Health LLC |
Operational/Managerial Control | Jun 1, 2020 | |
| Adp of the SNF | Jun 1, 2020 | ||
| Matthew Euson |
5% Or Greater Mortgage Interest | May 1, 2020 | 100% |
| Operational/Managerial Control | May 1, 2020 | ||
| Adp of the SNF | May 1, 2020 | ||
| Rex McKinney |
Corporate Officer |
May 1, 2020 | 100% |
| Bryan K Lindsay |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Catherine Keck |
Corporate Officer |
May 1, 2020 | 100% |
| RSCR Management LLC |
Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Kara Riddell |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Decatur County Memorial Hospital |
5% Or Greater Direct Ownership Interest | May 1, 2020 | 100% |
| Operational/Managerial Control | Jul 1, 2020 | ||
| Adp of the SNF | Jul 1, 2020 | ||
| Melanie Fauth |
Adp of the SNF | Jan 1, 2025 | |
| Euson Lindsey Health Holdings LLC |
Adp of the SNF | Jun 1, 2020 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Morning Breeze Retirement Community and Healthcare Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Apr 15, 2015 Apr 15, 2015 Apr 15, 2015 |
| Auburn Village |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2019 |
| Tree City Medical Partners |
Rural health clinic | Operational/Managerial Control | Mar 1, 2011 |
| Decatur County Primary Care |
Rural health clinic | Operational/Managerial Control (100%) | Mar 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200617000373 | IN | Part a Provider - Skilled Nursing Facility | 7315837671 | Practice locations: Whitestown, IN |
National Provider Directory
- Tax ID family
- Decatur County Mem Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
6712 Restoracy Drive
Whitestown, IN 46075-0089
Mailing address
720 North Lincoln Street
Greensburg, IN 47240-1398
Phone (812) 663-4331
Other names
- The Restoracy of Whitestown
Other providers in Whitestown, IN
- Shaun Curtis
- Taylor Christine Daugherty
- Stacia Davis
- Stephanie Marie Davis
- Jordan Tyler Deboer
- Thomas Dellavilla
- Michael Kim Deming
- Dental Professionals of Indiana, P.C.
- Douglas Wayne Deurloo
- Amelia Lynn Dick
All providers in Whitestown, 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 Apr 17, 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.