NPIMap

Organization Active NPI

Witham Memorial Hospital

  • Skilled Nursing Facility
  • Columbus, IN
National Provider Identifier
1720264591
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
11-000572-1 Issued in IN
Legal business name
WITHAM MEMORIAL HOSPITAL
Practice address
3550 Central Ave
Columbus, IN 47203-2035
Phone
(812) 379-9669
Fax
(812) 378-5248
NPI assigned
Jan 11, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kelly Braverman
Title
Ceo, President
Phone
(765) 481-8100

Owners & managing parties with NPI records 1

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

Corporate family (same tax ID) 36

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

View all 36

Facilities with the same owner 31

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

View all 31

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willow Crossing Health & Rehabilitation CenterCCN 155535
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jun 30, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
112102.3 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

Medicare participation

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

Skilled nursing facility certification: CCN 155535

Medicare enrollment files
Legal name
WITHAM MEMORIAL HOSPITAL
Doing business as
WILLOW CROSSING HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 30, 1994
Last certification
Feb 18, 2025
Beds
112
Ownership / control type
County
Multi-facility organization
Magnolia Health Systems
Organization structure
GovernmentNon-profit
Enrollment address
3550 Central Ave
Columbus, IN 47203-2035
Nursing home name
WILLOW CROSSING HEALTH & REHABILITATION CENTER

All disclosed owners & managing parties 17

Medicare enrollment files

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

NameRoleSinceShare
Stuart B Reed Individual Operational/Managerial ControlPresident Nov 1, 2011
Magnolia Health Systems Inc Organization, Indianapolis, IN Corporation Adp of the SNF Nov 1, 2011
Jonathan Ward Individual Adp of the SNF Nov 1, 2011
Julie Reagan Individual Corporate DirectorBoard Trustee Sep 25, 2024
Kelly Braverman Individual Corporate OfficerCeo, President Dec 1, 2021
Alisha Miller Individual Operational/Managerial Control Oct 29, 2025
Adp of the SNF Oct 29, 2025
Witham Memorial Hospital Organization, Lebanon, IN 5% Or Greater Direct Ownership Interest Nov 1, 2011 100%
Daniel E Sellers Individual Corporate OfficerSVP-Cfo Jun 20, 2024
Magnolia Health Management XI LLC Organization, Indianapolis, IN LLC, For-profit Operational/Managerial Control Nov 1, 2011 100%
Michael Jason Hornbecker Individual Corporate DirectorBoard Trustee Jan 1, 2024
Magnolia Health Systems 65 LLC Organization, Indianapolis, IN LLC Adp of the SNF Nov 14, 2025
Andrea Castetter Individual Corporate Director Jan 1, 2023
Sabra Health Care Limited Partnership Organization, Tustin, CA Adp of the SNF Nov 1, 2011
Ibrar Faqir Paracha Individual Operational/Managerial Control Oct 29, 2025
Adp of the SNF Oct 29, 2025
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

All facility ownership & control disclosures 31

Medicare enrollment files

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
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
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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20120224000205 IN Part a Provider - Skilled Nursing Facility 4082523170 Practice locations: Columbus, IN

National Provider Directory

National Provider Directory
Tax ID family
Hoosier Enterprises II Inc (37 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 11-000572-1 IN Primary

Addresses

NPPES NPI Registry

Primary practice location

3550 Central Ave
Columbus, IN 47203-2035

Mailing address

9480 Priority Way West Dr
Indianapolis, IN 46240-1470
Phone (317) 818-1240

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100267710MedicaidIN

Other names 1

NPPES NPI Registry
  • WILLOW CROSSING HEALTH AND REHABILITATION CENTER Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2022.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1720264591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 PRIORITY WAY WEST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401470",
            "telephone_number": "317-818-1240",
            "fax_number": "317-818-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 CENTRAL AVE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472032035",
            "telephone_number": "812-379-9669",
            "fax_number": "812-378-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "BRAVERMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "765-481-8100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "11-000572-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100267710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILLOW CROSSING HEALTH AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WILLOW CROSSING HEALTH AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.