NPIMap

Organization Active NPI

Witham Memorial Hospital

Doing business as Westminster Village Kentuckiana

  • Skilled Nursing Facility
  • Clarksville, IN
National Provider Identifier
1720082456
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5471 Issued in IN
Legal business name
WITHAM MEMORIAL HOSPITAL
Doing business as
Westminster Village Kentuckiana
Practice address
2210 Greentree N
Clarksville, IN 47129-8958
Phone
(812) 282-5911
Fax
(812) 285-9830
NPI assigned
Jun 10, 2005
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Mr. John Bartle Jr.
Title
Authorized Official
Phone
(317) 525-0225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5471 IN Primary

Addresses

Primary practice location

2210 Greentree N
Clarksville, IN 47129-8958

Mailing address

PO Box 501188
Indianapolis, IN 46250-6188
Phone (317) 806-6775

Other identifiers 1

IdentifierTypeStateIssuer
100266130MedicaidIN

Other names 1

  • Westminster Village Kentuckiana Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230511001280 IN Part A Provider - Skilled Nursing Facility 3173989480 Practice locations: Clarksville, IN
O20260710000371 IN Part A Provider - Skilled Nursing Facility 4082523170

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720082456. Details of each certification follow.

Skilled nursing facility certification: CCN 155191

Legal name
WITHAM MEMORIAL HOSPITAL
Doing business as
WESTMINSTER VILLAGE KENTUCKIANA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1982
Last certification
Dec 10, 2024
Beds
244 (94 certified)
Ownership / control type
County
Organization structure
OtherNon-profit
Enrollment address
2210 Greentree N
Clarksville, IN 47129-8958

Care Compare: Nursing home

Medicare Care Compare
Listed as
Westminster Village KentuckianaCCN 155191 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jun 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9466.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
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.

View all 36

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 22

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 Sep 25, 2024
Marc G Flores Individual Corporate OfficerPresident Apr 15, 2025
Kelly Braverman Individual Corporate Officer Dec 1, 2021
Operational/Managerial Control Apr 1, 2023
John Keaton Individual Operational/Managerial Control Nov 1, 2025
NHC HV Pul Inc Organization, Indianapolis, IN Corporation Adp of the SNF Jul 10, 2026
Seacoast of Clarksville LLC Organization, Ocala, FL LLC 5% Or Greater Security Interest Oct 1, 2022 27%
2 Bluebirds, LLC Organization, Selma, IN LLC Adp of the SNF Jul 10, 2026
Witham Memorial Hospital Organization, Clarksville, IN 5% Or Greater Direct Ownership Interest Apr 1, 2023 100%
Spring Valley in, LLC Organization, Indianapolis, IN LLC Operational/Managerial Control Apr 14, 2025
Daniel E Sellers Individual Corporate OfficerSVP-Cfo Jun 20, 2024
Managing Control - Governing BodySVP-Cfo Jun 20, 2024
Brenda Bannon Individual Operational/Managerial Control Sep 29, 2025
Michael Jason Hornbecker Individual Corporate DirectorBoard Trustee Jan 1, 2024
Marla Cook Individual Operational/Managerial Control Apr 15, 2025
Andrea Castetter Individual Corporate DirectorBoard Trustee Jan 1, 2023
Claude a Hawkins Individual Corporate DirectorBoard Trustee Sep 1, 2013
Superlative Healthcare LLC Organization, Selma, IN LLC Operational/Managerial Control Apr 15, 2025
John W Brand Individual Corporate DirectorBoard Trustee Jan 1, 2015
William Enloe Hoke Individual Corporate DirectorMedical Director Apr 15, 2025
Edward Fodrea Individual Operational/Managerial Control Apr 15, 2025
Christopher T Cook Individual Operational/Managerial Control Apr 15, 2025
Scott Buckles Individual Corporate DirectorBoard Member Apr 15, 2025
Brett Bayston Individual Corporate DirectorBoard Trustee Jan 1, 2023

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
McGivney Health Care CenterCarmel, IN, CCN 155855 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Brooke Knoll VillageAvon, IN, CCN 155814 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
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 3

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": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1720082456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 501188",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462506188",
            "telephone_number": "317-806-6775",
            "fax_number": "317-806-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 GREENTREE N",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471298958",
            "telephone_number": "812-282-5911",
            "fax_number": "812-285-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "BARTLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "317-525-0225",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "5471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100266130",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westminster Village Kentuckiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, IN

Sources for this page

Verify at the official NPI Registry.