Woodlawn Hospital
Organization Active NPI Rural Health Clinic/Center · Rochester, IN
NPI 1699338574 · NPPES record last updated Apr 17, 2019
Key facts
- NPI
- 1699338574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- WOODLAWN HOSPITAL
- Practice address
- 1400 E 9TH St
Rochester, IN 46975-8931 - Phone
- (574) 223-2020
- Fax
- (574) 224-1103
- NPI assigned
- Apr 17, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- WOODLAWN HOSPITAL
Authorized official
- Name
- John Kraft
- Title
- Cfo
- Phone
- (574) 224-1118
Owners & managing parties with NPI records 16
Owned or controlled facilities with NPI records 15
Other NPIs with the same Medicare PAC ID 16
Corporate family (same tax ID) 25
Related certifications (CCN) 1
Facilities with the same owner 15
Practitioners 32
-
James Timothy Aldridge, D.O.
-
Omazonna Amadi, MD
-
Leigh Barts, FNP-C
-
Joseph Peter Binfet, M.D.
-
Michael J Brubaker, D.O.
-
Keri Rae Federspiel, FNP
-
Jerrod A Feldman, MD
-
Kelly Ann Friar, PA-C
-
Shannon Michelle Guckien, FNP-BC
-
Monzur Haque, M.D.
-
Kelsey Heckaman, FNP
-
Jennifer Hensley, FNP
-
Gina L Moore, FNP
-
Janell Nicole Mulligan, FNP-C
-
John E Nile, D.O.
-
Kevin O'Brien, MD
-
Teresa Marie Perkins, APRN, BC
-
Eric Rindlisbacher, DPM
-
Elizabeth Rodriguez, FNP-BC
-
Debra F Sanders, MD
-
Brigitte R Selio, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Rural health clinic certification: CCN 158552
- Legal name
- WOODLAWN HOSPITAL
- Doing business as
- WOODLAWN MEDICAL PROFESSIONALS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Apr 13, 2020
- Last certification
- Apr 13, 2020
- Ownership / control type
- 2B
- Organization structure
- Other · Non-profit
- Enrollment address
- 1400 E 9TH St
Rochester, IN 46975-8931 - Related CCNs
- 151313
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Alison M Heyde |
Corporate Director |
Sep 9, 2019 | |
| Alan Jay Fisher |
Corporate Officer |
Jun 13, 2022 | |
| Brandon Miller |
Corporate Officer |
Apr 7, 2025 | |
| Terri L Johnson |
Contracted Managing Employee |
Jun 6, 2022 | 5% |
| Woodlawn Hospital |
5% Or Greater Direct Ownership Interest | Jan 1, 2012 | 100% |
| Operational/Managerial Control | Aug 1, 2013 | 100% | |
| Harry Webb |
Corporate Officer |
Oct 15, 2023 | |
| Gregory Lee Mellinger |
Corporate Director |
Jun 13, 2022 | |
| Glen W Bode |
Corporate Director |
Dec 9, 2022 | |
| Kendra Chudzynski |
Corporate Director |
Oct 15, 2024 |
All facility ownership & control disclosures 15
| Facility | Type | Role | Since |
|---|---|---|---|
| Woodlawn Hospital |
Hospital | Operational/Managerial Control | Jan 8, 2010 |
| Woodlawn Hospital |
Hospital | Operational/Managerial Control | Jan 8, 2010 |
| Grace Village Health Care Facility |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
May 1, 2013 May 28, 2025 |
| Wesley Manor Health Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
Apr 8, 2013 Mar 12, 2025 |
| Timbercrest Church of the Brethren Home |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
| Peabody Retirement Community |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
Oct 31, 2014 Dec 17, 2025 |
| Greencroft Healthcare |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2015 |
| Hamilton Grove |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
Nov 1, 2015 Dec 8, 2025 |
| Southfield Village |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2015 |
| Oak Grove Christian Retirement Village |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) 5% Or Greater Indirect Ownership Interest (100%) Adp of the SNF |
Jan 1, 2016 Jan 1, 2016 Nov 17, 2025 |
| Golden Years Homestead |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2018 |
| Argos Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2012 Aug 1, 2013 |
| Akron Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2012 Aug 1, 2013 |
| Shafer Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2012 Jan 1, 2012 |
| Fulton County Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2012 Aug 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190701001451 | IN | Part a Provider - Rural Health Clinic | 4082506993 | Practice locations: Rochester, IN |
National Provider Directory
- Tax ID family
- Akron Medical
- Part of
- Akron Medical
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1400 E 9TH St
Rochester, IN 46975-8931
Mailing address
1400 E 9TH St
Rochester, IN 46975-8931
Phone (574) 223-3141
Other names
- Woodlawn Medical Professionals
Other providers in Rochester, IN
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Woodlawn Hospital
- Rachel Woods
All providers in Rochester, IN · Rural Health Clinic/Center 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, 2019. 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.