PERSIMMON RIDGE REHABILITATION CENTRE
NPI 1811196843
Skilled Nursing Facility in Portland, IN

Active since July 11, 2007CLIA 15D0360348 · Waiver
3/5
Overall Rating
200 N PARK ST, PORTLAND, IN 47371(260) 726-9355 Get Directions Write a Review

NPPES record last updated: June 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Persimmon Ridge Rehabilitation Centre NPPES

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

PERSIMMON RIDGE REHABILITATION CENTRE (NPI 1811196843) is a healthcare organization registered as a skilled nursing facility in Portland, Indiana and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Kelly Braverman, Ceo, President, as its authorized official.

NPPES Registry Identity

NPI1811196843
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWITHAM MEMORIAL HOSPITAL
Location Address200 N PARK STPortland, IN 47371-1249
Mailing Address9480 Priority Way West DrIndianapolis, IN 46240-1470 · (317) 818-1240 · Fax (317) 818-1022
Organization SubpartNo
Authorized OfficialKelly BravermanCeo, President · (765) 485-8100
Enumeration DateJuly 11, 2007
Last NPPES UpdateJune 24, 2022
NPPES CertifiedJune 24, 2022
NPI 1811196843 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 · 11-000148-1
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.
200 N PARK ST, Portland, IN 47371

Other Names 1

Doing Business AsPersimmon Ridge Rehabilitation Centre

Other Identifiers 1

Medicaid100275500IN

Accepted Insurance

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 15D0360348

Persimmon Ridge Rehab Centre · Portland, IN
Active · expires Aug 31, 2026
CLIA Number15D0360348
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMelinda Sue Hodgson
Laboratory Phone(260) 726-9355
Laboratory LocationPersimmon Ridge Rehab Centre200 N Park St, Portland, IN 47371
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Persimmon Ridge Rehabilitation Centre (CMS certification number 155526), from CMS Care Compare.

Persimmon Ridge Rehabilitation Centre

Nursing home · Portland, IN
3/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number155526
Certified Beds100 beds91 residents per day on average
Medicare & Medicaid Participant SinceJune 30, 1994
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
35.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.16 · LPN 0.6 · RN 0.5
3.26 hrs per resident per day
Weekend Nurse Staffing
3.04 hrs per resident per day
Physical Therapist Staffing
0.02 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
14.6%
Registered Nurse Turnover
25%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Infection-Control Citations
0
Fines
1 totaling $9,750.00
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES

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

Skilled Nursing Facility
200 N PARK ST
PORTLAND, IN 47371

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 1811196843. It was assigned to this organization in the NPPES registry on July 11, 2007. The provider is doing business as Persimmon Ridge Rehabilitation Centre.

Where is Witham Memorial Hospital located?

Witham Memorial Hospital is located at 200 N Park St, Portland, IN 47371. The listed phone number is (260) 726-9355.

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 15D0360348) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Witham Memorial Hospital a Medicare-certified nursing home?

Yes. Persimmon Ridge Rehabilitation Centre is a Medicare-certified nursing home with 100 certified beds.

What quality rating does Witham Memorial Hospital have?

CMS rates Persimmon Ridge Rehabilitation Centre 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Witham Memorial Hospital accept?

Health plans from UnitedHealthcare list Witham Memorial Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Witham Memorial Hospital was last updated on June 24, 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.