WOODBRIDGE HEALTH CAMPUS
NPI 1639203532
Skilled Nursing Facility in Logansport, IN

Active since March 15, 2007CLIA 15D1011797 · Waiver
602 WOODBRIDGE AVE, LOGANSPORT, IN 46947(574) 753-3223(574) 753-3226 Get Directions Write a Review

NPPES record last updated: March 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Woodbridge Health Campus NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WOODBRIDGE HEALTH CAMPUS (NPI 1639203532) is a healthcare organization registered as a skilled nursing facility in Logansport, Indiana and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Kelly Braverman, Ceo, President, as its authorized official.

NPPES Registry Identity

NPI1639203532
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWITHAM MEMORIAL HOSPITAL
Location Address602 WOODBRIDGE AVELogansport, IN 46947-1661
Mailing AddressPo Box 221648Louisville, KY 40252-1648 · (502) 412-5847
Fax(574) 753-3226
Organization SubpartNo
Authorized OfficialKelly BravermanCeo, President · (765) 485-8100
Enumeration DateMarch 15, 2007
Last NPPES UpdateMarch 26, 2022
NPPES CertifiedMarch 26, 2022
NPI 1639203532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IN · 06-003691-1
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
602 WOODBRIDGE AVE, Logansport, IN 46947

Other Names 1

Doing Business AsWoodbridge Health Campus

Other Identifiers 1

Medicaid200456230IN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D1011797

Bd Trustees Of Flavius J Witham Mem Hosp Dba Woodbridge Health Campus · Logansport, IN
Active · expires Apr 22, 2027
CLIA Number15D1011797
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorJennifer Sales
Laboratory Phone(574) 753-3223
Laboratory LocationBd Trustees Of Flavius J Witham Mem Hosp Dba Woodbridge Health Campus602 Woodbridge Ave, Logansport, IN 46947
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinical Nurse Specialist (Long-Term Care)
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
Clinical Nurse Specialist (Long-Term Care)
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
Occupational Therapist
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
Licensed Practical Nurse
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
Registered Nurse
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
Skilled Nursing Facility
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Witham Memorial Hospital's NPI number?

The NPI number for Witham Memorial Hospital is 1639203532. It was assigned to this organization in the NPPES registry on March 15, 2007. The provider is doing business as Woodbridge Health Campus.

Where is Witham Memorial Hospital located?

Witham Memorial Hospital is located at 602 Woodbridge Ave, Logansport, IN 46947. The listed phone number is (574) 753-3223.

What is Witham Memorial Hospital's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Witham Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1011797) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Witham Memorial Hospital was last updated on March 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.