NPIMap

Organization Active NPI

Putnam County Hospital

  • Critical Access Hospital
  • Greencastle, IN
National Provider Identifier
1912947490
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
06 004765-2 Issued in IN
Legal business name
PUTNAM COUNTY HOSPITAL
Practice address
1542 S Bloomington St
Greencastle, IN 46135-2212
Phone
(765) 653-5121
Fax
(765) 655-2625
NPI assigned
Jun 7, 2006
Last updated
May 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
PUTNAM COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
Mr. Roger Boruff
Title
Cfo
Phone
(765) 655-2621

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 06 004765-2 IN
Critical Access Hospital 282NC0060X 06 004765-2 IN Primary

Addresses

Primary practice location

1542 S Bloomington St
Greencastle, IN 46135-2212

Mailing address

1542 S Bloomington St
Greencastle, IN 46135-2212
Phone (765) 653-5121

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060306000038 IN Part A Provider - Critical Access Hospital 1951396605 Receives reassigned benefits from 32 practitioners
Practice locations: Greencastle, IN
O20080508000341 IN Part A Provider - Critical Access Hospital 1951396605 Practice locations: Greencastle, IN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1912947490. Details of each certification follow.

Hospital certification: CCN 151333

Legal name
PUTNAM COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 31, 2005
Last certification
Dec 7, 2011
Beds
25
Ownership / control type
Local
Organization structure
CorporationNon-profit
Enrollment address
1542 S Bloomington St
Greencastle, IN 46135-2212

Hospital certification: CCN 15Z333

Legal name
PUTNAM COUNTY HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
1542 S Bloomington St
Greencastle, IN 46135-2212

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Putnam County HospitalCCN 151333 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Putnam County Hosp26 organizations share this tax ID, including this one
Part of
Putnam County Hosp

Other organizations with this tax ID 25

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

View all 25

Locations

1542 S Bloomington St
#1
Greencastle, IN 46135

1542 S Bloomington St
Ste 300
Greencastle, IN 46135

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Matthew L Headley Individual Corporate OfficerBoard Member Jan 1, 2012
Corporate DirectorBoard Member Jan 1, 2012
Corporate OfficerPutnam Cty Hospital Board Member Jan 1, 2012
Corporate DirectorPutnam Cty Hospital Board Member Jan 1, 2012
Putnam County Hospital Organization, Greencastle, IN Corporation, Non-profit Operational/Managerial Control Jul 1, 1966
5% Or Greater Direct Ownership Interest Apr 30, 2015 100%
Keith P Landry Individual Corporate DirectorSecretary/Treasurer Sep 1, 2020
Arnold D Bray Individual Corporate DirectorPresident Jan 1, 2002
James a Nerone Individual Corporate DirectorCfo Dec 1, 2024
W-2 Managing EmployeeCfo Dec 1, 2024
Operational/Managerial Control Dec 1, 2024
Janice M Fry Individual Corporate OfficerBoard Member Mar 1, 2008
Corporate DirectorBoard Member Mar 1, 2008
Corporate OfficerPutnam Cty Hospital Board Member Mar 1, 2008
Corporate DirectorPutnam Cty Hospital Board Member Mar 1, 2008
Bethany Combs Individual Corporate DirectorBoard Member Dec 1, 2024
Dennis a Weatherford Individual Corporate DirectorCeo Jan 1, 1999
W-2 Managing EmployeeCeo Sep 25, 2014
Operational/Managerial ControlCeo Jan 1, 1999
Corporate DirectorCeo Jun 1, 2000
W-2 Managing EmployeeCeo Jan 1, 2008
Wendell Underwood Individual Corporate OfficerBoard Member Dec 1, 2024
Corporate DirectorBoard Member Dec 1, 2024
Mark Wood Individual Corporate OfficerBoard Member Dec 1, 2024
Corporate DirectorBoard Member Dec 1, 2024
Katrina Ann Lewis Individual Corporate DirectorBoard Member Dec 21, 2022
Corporate OfficerBoard Member Dec 21, 2022
Debra K Sillery Individual Corporate DirectorBoard Member Mar 1, 2026

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 24

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Waters of PrincetonPrinceton, IN, CCN 155275 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Providence Health Care CenterSaint Mary of the Woods, IN, CCN 155802 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2013
The Waters of GreencastleGreencastle, IN, CCN 155202 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 23, 2014
The Waters of MartinsvilleMartinsville, IN, CCN 155183 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 May 23, 2014
Jun 9, 2026
Cobblestone Crossings Health CampusTerre Haute, IN, CCN 155772 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Owen Valley Rehabilitation and Healthcare CenterSpencer, IN, CCN 155661 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Mill Pond Health CampusGreencastle, IN, CCN 155736 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Wellbrooke of AvonIndianapolis, IN, CCN 155811 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Wellbrooke of CrawfordsvilleCrawfordsville, IN, CCN 155812 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Vernon Health & RehabilitationWabash, IN, CCN 155810 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Hutsonwood at BrazilBrazil, IN, CCN 155503 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jun 1, 2015
Sep 19, 2025
Harrisons Crossings Health CampusTerre Haute, IN, CCN 155830 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Richland Bean Blossom Health Care CenterEllettsville, IN, CCN 155523 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2015
Century Villa Health CareGreentown, IN, CCN 155510 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2018
Northview Health and LivingAnderson, IN, CCN 155718 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2018
Summit Health and LivingSummitville, IN, CCN 155839 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2018
Elwood Health and LivingElwood, IN, CCN 155522 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2018
The Waters of HuntingburgHuntingburg, IN, CCN 155217 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2020
The Waters of ScottsburgScottsburg, IN, CCN 155494 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2020
Family Medicine of CloverdaleCloverdale, IN, CCN 158513 Rural health clinic Operational/Managerial Control Apr 2, 2013
Putnam Pediatrics and Internal MedicineGreencastle, IN, CCN 158515 Rural health clinic Operational/Managerial Control Apr 2, 2013
North Putnam Family HealthcareBainbridge, IN, CCN 158514 Rural health clinic Operational/Managerial Control Apr 2, 2013
Family Medicine of GreencastleGreencastle, IN, CCN 158572 Rural health clinic Operational/Managerial Control Oct 31, 2020
Putnam Prompt CareGreencastle, IN, CCN 158579 Rural health clinic Operational/Managerial Control Dec 1, 2023

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

Affiliated clinicians 116

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

View all 116

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1912947490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "765-653-5121",
            "fax_number": "765-655-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352212",
            "telephone_number": "765-653-5121",
            "fax_number": "765-655-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUTNAM COUNTY HOSPITAL",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "BORUFF",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-655-2621",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IN",
            "license": "06 004765-2",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IN",
            "license": "06 004765-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greencastle, IN

Sources for this page

Verify at the official NPI Registry.