WOODLAWN HOSPITAL (NPI# 1285723734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285723734 |
| Entity Type | Organization |
| Organization Name | WOODLAWN HOSPITAL |
| Other Organization Name | GRACE VILLAGE HEALTH CARE FACILITY |
| Practice Address |
337 Grace Village Dr Winona Lake IN 46590-5774 |
| Practice Telephone | 5743726200 |
| Practice Fax Number | 5743726386 |
| Mailing Telephone | 5743726200 |
| Mailing Fax Number | 5743726386 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-11-25 |
| Authorized Official Name | JOHN ALLEY (PRESIDENT/CEO) |
| Authorized Official Telephone | 5742233141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 060005011 | IN | Nursing & Custodial Care Facilities |
| N | 314000000X | Skilled Nursing Facility | 060005011 | IN | Nursing & Custodial Care Facilities |
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 060005011 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100266260A | 05 | |
| IN | ANTHEM PIN NUMBER | 000000097895 | 01 |
| IN | RBA HOME NUMBER | 2297 | 01 |
| Other Name | Type Code |
|---|---|
| Grace Village Health Care Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174186894 | Woodlawn Hospital | Clinic/Center | 100 E Dunn St, Fulton, IN 46931 | 2019-04-18 |
| 1710540695 | Woodlawn Hospital | Clinic/Center | 105 N Sr 14, Akron, IN 46910 | 2019-04-17 |
| 1114254190 | Woodlawn Hospital | Family Medicine | 100 E Dunn Street, Fulton, IN 49631 | 2009-11-11 |
| 1326180803 | Woodlawn Hospital | Skilled Nursing Facility | 3136 Goeglein Rd, Fort Wayne, IN 46815-6685 | 2007-02-13 |
| 1356405526 | Woodlawn Hospital | Durable Medical Equipment & Medical Supplies | 2310 E State Road 14, Rochester, IN 46975 | 2006-12-21 |
| 1043382625 | Woodlawn Hospital | Nurse Practitioner | 105 St Rd 14 N, Akron, IN 46910 | 2006-11-15 |
| 1639241227 | Woodlawn Hospital | Family Medicine | 530 N Michigan, Argos, IN 46501 | 2006-11-15 |
| 1073557617 | Woodlawn Hospital | Assisted Living Facility | 2201 East St, North Manchester, IN 46962-9654 | 2006-06-15 |
| 1235113945 | Woodlawn Hospital | Skilled Nursing Facility | 221 W Division St, Demotte, IN 46310-9566 | 2005-12-06 |
| 1982686242 | Woodlawn Hospital | Skilled Nursing Facility | 9601 Union Rd, Plymouth, IN 46563 | 2005-11-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WOODLAWN HOSPITALITY GROUP LLC | 6719 Ne 18th Ave, Portland, OR 97211 |
| System for Award Management (SAM) Entities | WOODLAWN HOSPITALITY, LLC | 8632 Woodlawn Ct, Alexandria, VA 22309 |
| Street Address |
337 GRACE VILLAGE DR |
| City | WINONA LAKE |
| State | IN |
| Zip Code | 46590-5774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962616292 | National Fellowship Brethren Retirement Homes, Inc. | Voluntary or Charitable | 337 Grace Village Dr, Winona Lake, IN 46590-5774 | 2007-05-09 |
| 1629295985 | Helene Marie Mcnulty | Occupational Therapist | 337 Grace Village Dr, Winona Lake, IN 46590-5774 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447800347 | Jennifer Owens | Technician | 1429 Durham Ct, Winona Lake, IN 46590 | 2019-09-13 |
| 1457406548 | Leslie Plumlee | Pharmacist | 2998 East Saint Andrews Road, Winona Lake, IN 46590 | 2007-01-25 |
| 1598716078 | William Caraway Winn | Pharmacist | 2280 Provident Ct, Warsaw, IN 46590 | 2006-05-12 |
| 1295969657 | Steven Morrison | Social Worker | 1 Park Ave, Suite 203, Winona Lake, IN 46590-1074 | 2009-05-13 |
| 1730420928 | Denise Henriette O'daniels | Occupational Therapy Assistant | 1801 Park Ave, Winona Lake, IN 46590-1638 | 2013-03-13 |
| 1316354608 | Shannon Baxter | Advanced Practice Midwife | 845 S 250 E, Winona Lake, IN 46590-5700 | 2014-07-17 |
| 1851888150 | Megan Fisher | Specialist/Technologist | 1093 S 250 E, Winona Lake, IN 46590-5703 | 2018-04-23 |
| 1700277787 | Jeffrey Blosser | Counselor | 2426 E Pierceton Rd, Winona Lake, IN 46590-5713 | 2015-02-11 |
| 1437401635 | Lifetouch Ministries, Inc. | Counselor | 2426 East Pierceton Road, Winona Lake, IN 46590-5713 | 2012-10-11 |
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
| 1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
| 1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
| 1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
| 1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
| 1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
| 1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
| 1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
| 1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | WINONA LAKE |
| Zip Code | 46590 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.