Parkview Wabash Hospital, Inc.
Organization Active NPI Rural Health Clinic/Center · North Manchester, IN
NPI 1922515907 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1922515907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- PARKVIEW WABASH HOSPITAL, INC.
- Practice address
- 1104 N Wayne St
North Manchester, IN 46962-1001 - Phone
- (260) 982-2102
- NPI assigned
- Dec 29, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- PARKVIEW WABASH HOSPITAL, INC.
Authorized official
- Name
- Mrs. Jessica Lee-Hansen
- Title
- Cfo
- Phone
- (312) 388-0125
Owners & managing parties with NPI records 6
-
William Rauh, M.D.
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 4
Related certifications (CCN) 1
Facilities with the same owner 1
Practitioners 31
-
Shannon Elise Brisbin, PA-C
-
Jamie C Broekhuizen, D.O.
-
Brian Davault, MD
-
Svetlana V Hagan, MD
-
Pamela S Higgins, MD
-
Karyn Jett, NP
-
Emeri C Kinnamon, NP
-
Michele E Meredith, FNP
-
Amy Beth Miller, LCSW
-
Dana Oberg, NP
-
James Michael Roush, DNP
-
Riel Sarno, M.D.
-
Roy Small, DO
-
Grace L Stanley, NP
-
Carissa Vancamp, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0358909 | Parkview Wabash Health Clinic North | Certificate of waiver | Dec 18, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Rural health clinic certification: CCN 158541
- Legal name
- PARKVIEW WABASH HOSPITAL INC
- Doing business as
- PARKVIEW WABASH HEALTH CLINIC - NORTH MANCHESTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jun 5, 2019
- Last certification
- Jun 5, 2019
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1104 N Wayne St
North Manchester, IN 46962-1001 - Related CCNs
- 151310
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Douglas Hilton Sparks |
Corporate Officer | Jan 1, 2025 | |
| Parkview Wabash Hospital Inc |
5% Or Greater Direct Ownership Interest | Jun 1, 2018 | 100% |
| Operational/Managerial Control | Jan 1, 2018 | ||
| David Pyle |
Corporate Officer |
Jan 1, 2026 | |
| David Scheblo |
Corporate Officer | Jan 1, 2025 | |
| William a Rauh |
Corporate Officer | Jan 1, 2025 | |
| Benjamin Vanderpool |
Corporate Officer | Jan 1, 2025 | |
| Jessica Lee-Hansen |
Corporate Officer |
Jan 1, 2026 | |
| Corporate Director |
Jan 1, 2026 | ||
| W-2 Managing Employee |
Aug 3, 2025 | ||
| Andy Bain |
Corporate Officer | Jan 1, 2025 | |
| Rick Henvey |
W-2 Managing Employee |
Dec 31, 2006 | |
| Debra a Potempa |
W-2 Managing Employee | Apr 17, 2022 | |
| Nathan Fansher |
Corporate Officer |
Jan 1, 2026 | |
| Amanda Lopez |
Corporate Officer | Jan 1, 2025 | |
| Amber Lewis |
Corporate Officer |
Jan 1, 2026 | |
| Sam McFadden |
Corporate Officer | Jan 1, 2025 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Parkview Wabash Health Clinic - Kissinger Drive |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2018 Jan 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190110002044 | IN | Part a Provider - Rural Health Clinic | 0244553360 | Practice locations: North Manchester, IN |
National Provider Directory
- Tax ID family
- Parkview Wabash Hospital Inc
- Part of
- Parkview Wabash Hospital Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1104 N Wayne St
North Manchester, IN 46962-1001
Mailing address
1104 N Wayne St
North Manchester, IN 46962-1001
Phone (260) 982-2102
Other names
- North Manchester RHC
Other providers in North Manchester, IN
- North Manchester Pharmacies
- Orthopaedics Northeast, PC
- Palladino Enterprises LLC
- Matthew James Palladino
- Melissa Lynnae Parker
- Morgan Paul
- Jonathan Perkins
- Abigail Pfaffenbach
- Krystal Presl
- Shelly Prichard
All providers in North Manchester, 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 Mar 2, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.