NPIMap

Organization Active NPI

Parkview Logansport Hospital, Inc.

Doing business as Logansport Memorial Express Medical Center

  • Rural Health Clinic/Center
  • Logansport, IN
National Provider Identifier
1821648155
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PARKVIEW LOGANSPORT HOSPITAL, INC.
Doing business as
Logansport Memorial Express Medical Center
Parkview Logansport Walk-In Clinic
Practice address
3400 E Market St
Logansport, IN 46947-2295
Phone
(574) 722-9633
Fax
(574) 722-5987
NPI assigned
Sep 18, 2019
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
Stanton Risser
Title
Acfo
Phone
(260) 266-9380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

3400 E Market St
Logansport, IN 46947-2295

Mailing address

3400 E Market St
Logansport, IN 46947-2295
Phone (574) 722-9633

Other identifiers 1

IdentifierTypeStateIssuer
300117667MedicaidIN

Other names 2

  • LOGANSPORT MEMORIAL EXPRESS MEDICAL CENTER Doing business as
  • Parkview Logansport Walk-In Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251125000517 IN Part A Provider - Rural Health Clinic 8921500646 Practice locations: Logansport, IN
O20260126001326 IN Part B Supplier - Clinic/Group Practice 8921500646 Receives reassigned benefits from 18 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Logansport, IN; Peru, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821648155. Details of each certification follow.

Rural health clinic certification: CCN 158561

Legal name
PARKVIEW LOGANSPORT HOSPITAL INC
Doing business as
PARKVIEW LOGANSPORT WALK-IN CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 25, 2021
Last certification
May 25, 2021
Ownership / control type
2B
Most recent change of ownership
Jul 1, 2025 (1 total)
Organization structure
CorporationNon-profit
Enrollment address
3400 E Market St
Logansport, IN 46947-2295
Related CCNs
150072

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
15D1078070Parkview Logansport Walk-in Clinic3400 E Market St, Logansport, IN 46947Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Parkview Logansport Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
David Brumett Individual Corporate DirectorDirector Jul 1, 2025
Juli Johnson Individual Corporate DirectorDirector Jul 1, 2025
David Redweik Individual Corporate DirectorDirector Jul 1, 2025
Kathy Dunderman Individual Corporate DirectorDirector Jul 1, 2025
Scott Stebbins Individual Corporate DirectorDirector Jul 1, 2025
Parkview Health System Inc Organization, Fort Wayne, IN Chain home office 5% Or Greater Direct Ownership Interest Jul 1, 2025 100%
Darryl Hoover Individual Corporate DirectorDirector Jul 1, 2025
Sherri Gehlhausen Individual Corporate OfficerDelegated Official Officer Jul 1, 2025
Molly Cain Individual Corporate DirectorVice President and Coo, Director Jul 1, 2025
Thomas L Lane Individual Corporate DirectorDirector Jul 1, 2025
Tara McVay Individual Corporate OfficerPresident, Authorized Indv Offic Jul 1, 2025
W-2 Managing EmployeePresident, Authorized Indv Offic Jul 1, 2025
Brian Morrill Individual Corporate OfficerSecretary, Treasurer, Board of D Jul 1, 2025
Corporate DirectorDirector Jul 1, 2025
Jessica Y McClintock Glover Individual Corporate DirectorChairperson, Director/Officer Jul 1, 2025
Perry Gay Individual Corporate OfficerAuthorized Official, Officer, W2 Jul 1, 2025
W-2 Managing EmployeeOfficer Jul 1, 2025
Matt Lewellen Individual Corporate DirectorDirector Jul 1, 2025
Kyle L Rans Individual Corporate DirectorDirectors Jul 1, 2025
Gene Powlen Individual Corporate DirectorDirector Jul 1, 2025
Jon-Myckle D Price Individual Corporate OfficerVice Chair, Board of Directors Jul 1, 2025
Corporate DirectorDirector Jul 1, 2025
Stanton Risser Individual Corporate OfficerAcfo Jul 1, 2025
W-2 Managing EmployeeAcfo Jul 1, 2025
Michael Deitrich Individual Corporate DirectorDirector Jul 1, 2025
Jeanette Huntoon Individual Corporate OfficerAuthorized Official, Officer Jul 1, 2025

Owners & managing parties with NPI records 3

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

Facilities with the same owner 19

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

View all 19

Change-of-ownership history 2

DateEventCounterparty
Jul 1, 2025 Change of OwnershipThis provider was the buyer Logansport Memorial Express Medical CenterCCN 158561, IN, NPI 1821648155
Jul 1, 2025 Change of OwnershipThis provider was the seller Parkview Logansport Walk-in ClinicCCN 158561, IN, NPI 1821648155

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1821648155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472295",
            "telephone_number": "574-722-9633",
            "fax_number": "574-722-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472295",
            "telephone_number": "574-722-9633",
            "fax_number": "574-722-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKVIEW LOGANSPORT HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "RISSER",
        "authorized_official_first_name": "STANTON",
        "authorized_official_title_or_position": "ACFO",
        "authorized_official_telephone_number": "260-266-9380"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300117667",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOGANSPORT MEMORIAL EXPRESS MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LOGANSPORT MEMORIAL EXPRESS MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Parkview Logansport Walk-In Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.