WITHAM MEMORIAL HOSPITAL (NPI# 1619019791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619019791 |
| Entity Type | Organization |
| Organization Name | WITHAM MEMORIAL HOSPITAL |
| Other Organization Name | WITHAM HEALTH SERVICES |
| Practice Address |
2605 N Lebanon St Lebanon IN 46052-1476 |
| Practice Telephone | 7654858100 |
| Practice Fax Number | 7654858118 |
| Mailing Telephone | 7654858100 |
| Mailing Fax Number | 7654858118 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-01-19 |
| Authorized Official Name | MR. GEORGE POGAS (CFO) |
| Authorized Official Telephone | 7654858102 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 070050931 | IN | Hospital Units |
| Other Name | Type Code |
|---|---|
| WITHAM HEALTH SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902298557 | Witham Memorial Hospital | Pharmacy | 2705 N Lebanon St Ste 100, Lebanon, IN 46052-8621 | 2015-02-19 |
| 1194115386 | Witham Memorial Hospital | Skilled Nursing Facility | 12315 N Pennsylvania St, Carmel, IN 46032-6600 | 2015-01-27 |
| 1366843716 | Witham Memorial Hospital | Skilled Nursing Facility | 2402 South St, Lafayette, IN 47904-3063 | 2014-09-04 |
| 1942639695 | Witham Memorial Hospital | Skilled Nursing Facility | 2200 S Dixon Rd, Kokomo, IN 46902-6410 | 2013-11-04 |
| 1972939361 | Witham Memorial Hospital | Skilled Nursing Facility | 8405 Clearvista Pl, Indianapolis, IN 46256-3737 | 2013-09-18 |
| 1396171781 | Witham Memorial Hospital | Skilled Nursing Facility | 1635 N Arlington Ave, Indianapolis, IN 46218-5181 | 2013-09-18 |
| 1124360367 | Witham Memorial Hospital | Skilled Nursing Facility | 1 Silvercrest Dr, New Albany, IN 47150-7800 | 2013-03-26 |
| 1144564626 | Witham Memorial Hospital | Skilled Nursing Facility | 20 John Kissinger Dr, Wabash, IN 46992 | 2012-11-21 |
| 1366748386 | Witham Memorial Hospital | Skilled Nursing Facility | 269 Meadowview Dr, Peru, IN 46970-8996 | 2011-02-09 |
| 1306165915 | Witham Memorial Hospital | Skilled Nursing Facility | 814 S 6th St, Monticello, IN 47960-8199 | 2010-05-21 |
| Street Address |
2605 N LEBANON ST |
| City | LEBANON |
| State | IN |
| Zip Code | 46052-1476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700870060 | Doris E Taylor Austin | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2005-09-01 |
| 1396222733 | Bailey C Goodman | Physician Assistant | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2018-07-27 |
| 1598253577 | Charles E. Wade | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2018-04-25 |
| 1780126920 | Lacey N Christian | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052 | 2016-11-04 |
| 1053867572 | Mary Katherine Fuller-nave | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2016-08-26 |
| 1598112955 | Christina Seib Stinnette | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2016-05-16 |
| 1891175063 | Richele Kelly | Anesthesiology | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2015-06-03 |
| 1104220078 | Nicholas Osborne | Hospitalist | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2014-10-21 |
| 1588071914 | Witham Memorial Hospital | Skilled Nursing Facility | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2014-07-17 |
| 1184057671 | Laura Devlin | Nurse Practitioner | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2013-08-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316567647 | Meredith England Labrie | Behavioral Analyst | 110 Birchwood Drivve, Lebanon, IN 46052 | 2020-04-16 |
| 1710401492 | Kenzlie Ann Westerfield | Specialist/Technologist | 613 Countryside Drive, Lebanon, IN 46052 | 2017-08-03 |
| 1487040044 | Jenny L Essex | Social Worker | 1614 N. Lebanon St., Integrative Wellness, LLC, Lebanon, IN 46052 | 2015-04-10 |
| 1316177363 | Kathryn Elizabeth Ehrgott | Counselor | 1005 South Lebanon Street, Boone County Services, Lebanon, IN 46052 | 2009-07-23 |
| 1780838557 | Kathleen M Whitaker | Registered Nurse | 209 W North St, Lebanon, IN 46052 | 2008-11-06 |
| 1851551998 | James R Mcafee | General Practice | 1997 Terrace Ln, Lebanon, IN 46052 | 2008-06-12 |
| 1518021773 | Zulfiqar Ali Mirza | Internal Medicine | 2505 N Lebanon St Ste 220, Lebanon, IN 46052 | 2006-12-21 |
| 1316016108 | Russell Allen Lindner | Chiropractor | 3920 North State Road 39, Boone County Chiropractic Office, Lebanon, IN 46052 | 2006-11-07 |
| 1487755781 | Cowan Drugs Inc | Pharmacy | 112 N Lebanon St, Lebanon, IN 46052 | 2006-09-26 |
| 1558463992 | Cowan Drugs Inc | Pharmacy | 1639 N Lebanon St, Lebanon, IN 46052 | 2006-09-05 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821030842 | Vanderbilt University Medical Center | Psychiatric Unit | 500 Park Avenue, Lebanon, TN 37087-3721 | 2006-06-12 |
| 1477117273 | Vanderbilt University Medical Center | Psychiatric Unit | 500 Park Ave, Lebanon, TN 37087-3721 | 2019-04-26 |
| 1215390513 | Spring View Hospital LLC | Psychiatric Unit | 320 N Loretto Rd, Lebanon, KY 40033-1300 | 2016-04-04 |
| 1568649697 | Mountain States Health Alliance | Psychiatric Unit | 58 Carroll St, Lebanon, VA 24266-4510 | 2008-01-31 |
| 1023092053 | Mary Hitchcock Memorial Hospital | Psychiatric Unit | One Medical Center Dr, Lebanon, NH 03756-0001 | 2005-12-02 |
| 1871599308 | Russell County Medical Center, Inc | Psychiatric Unit | 58 Carroll Street, Lebanon, VA 24266 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376841395 | Memorial Hospital of South Bend | Psychiatric Unit | 420 N Niles Ave, South Bend, IN 46617-1918 | 2011-03-01 |
| 1760521140 | Otis R. Bowen Center | Psychiatric Unit | 1535 Provident Dr., Warsaw, IN 46580 | 2007-02-05 |
| 1811042237 | St. Marys Warrick Hospital, Inc. | Psychiatric Unit | 1116 Millis Avenue, Boonville, IN 47601 | 2007-01-24 |
| 1104998624 | Columbus Regional Hospital | Psychiatric Unit | 2400 East 17th St, Columbus, IN 47201-5351 | 2006-11-14 |
| 1821517533 | Indiana University Health Jay, Inc. | Psychiatric Unit | 500 W Votaw St, Portland, IN 47371-1322 | 2017-09-13 |
| 1922463454 | La Porte Hospital Company LLC | Psychiatric Unit | 1007 Lincolnway, La Porte, IN 46350-3201 | 2015-12-29 |
| 1396015251 | The Methodist Hospitals, Inc | Psychiatric Unit | 600 Grant St, Gary, IN 46402-6001 | 2012-01-10 |
| 1760751069 | Nicki Williamson, Msw, Lcsw, LLC | Psychiatric Unit | 101 W Kirkwood Ave, Suite 121, Bloomington, IN 47404-6129 | 2011-12-16 |
| 1730492018 | Indiana Clinic | Psychiatric Unit | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2010-07-15 |
| 1972788784 | James R Davis Md LLC | Psychiatric Unit | 2700 Vissing Park Rd, Jeffersonville, IN 47130-5989 | 2007-12-31 |
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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.