Active NPI
St. Joseph Health System, LLC
Doing business as Lutheran Downtown Hospital
- General Acute Care Hospital
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 05-005043-1
- Legal business name
- ST. JOSEPH HEALTH SYSTEM, LLC
- Doing business as
- Lutheran Downtown Hospital
- Practice address
- 702 Van Buren St
Fort Wayne, IN 46802-3697 - Phone
- (260) 425-3000
- Fax
- (260) 425-3222
- NPI assigned
- May 16, 2006
- Last updated
- Dec 1, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula M Lalor
- Title
- Director/Delegated Official
- Phone
- (629) 215-3953
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 05-005043-1 | IN | Primary |
Addresses
Primary practice location
702 Van Buren St
Fort Wayne, IN 46802-3697
Mailing address
15819 Collection Center Dr
Chicago, IL 60693-0158
Phone (260) 425-3000
Other names 1
- Lutheran Downtown Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040108000777 | IN | Part A Provider - Hospital | 5698686491 | Practice locations: Fort Wayne, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1023060472. Details of each certification follow.
Hospital certification: CCN 150047
- Legal name
- ST JOSEPH HEALTH SYSTEM LLC
- Doing business as
- LUTHERAN DOWNTOWN HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 5, 2005
- Beds
- 191 (170 certified)
- Ownership / control type
- Private (for profit)
- Organization structure
- LLC
- Incorporated
- Jun 16, 1998 in DE
- Enrollment address
- 702 Van Buren St
Fort Wayne, IN 46802-3697 - Hospital subgroups
- Acute care
Care Compare: Hospital
Medicare Care Compare- Listed as
- St Joseph Health System, LLC
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Statcare North
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Stellhorn Freestanding Emergency Dept
- Emergency Care Clinic/Center
- Fort Wayne, IN
- NPI 1699670604
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 4
Organizations listed as members of this organization in the National Provider Directory.
-
dba Lutheran Downtown Hospital
- Rehabilitation Hospital Unit
- Fort Wayne, IN
- NPI 1033163407
Member Of
-
dba St. Joseph Hospital Gero
- Psychiatric Hospital Unit
- Fort Wayne, IN
- NPI 1578517231
Member Of
-
dba Transitional Care Unit of St Joseph
- Skilled Nursing Facility
- Fort Wayne, IN
- NPI 1740234111
Member Of
-
dba St. Joseph Hospital Home Health Care
- Home Health Agency
- Fort Wayne, IN
- NPI 1104870583
Member Of
Locations
15819 Collection Ctr Dr
Chicago, IL 60693
6515 Stellhorn Rd
Fort Wayne, IN 46815
Phone (260) 435-7001
Ownership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Kevin J Hammons | Corporate Officer | Feb 1, 2019 | |
| Corporate Director | Jan 1, 2020 | ||
| Nathaniel K Summar | Corporate Director | Jul 15, 2017 | |
| Justin D Pitt | Corporate Officer | Mar 1, 2022 | |
| Corporate Director | Mar 1, 2022 | ||
| Twilla Lee | W-2 Managing Employee | Jan 18, 2021 | |
| William Bradley Cash | Corporate Officer | Jun 1, 2018 | |
| Hma-Tri Holdings LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2015 | 100% |
| Community Health Systems Inc | 5% Or Greater Indirect Ownership Interest | Jul 25, 2007 | 100% |
| Jason Kevin Johnson | Corporate Officer | Jan 6, 2020 | |
| Roman Gabriel Ottinger | Corporate Officer | Jan 6, 2020 | |
| DHFW Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jul 25, 2007 | 5.8% |
| Paula M Lalor | Corporate Director | Apr 1, 2017 | |
| Triad Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2015 | 100% |
| Tennyson Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2006 | 100% |
| Lutheran Health Network Investors LLC | 5% Or Greater Direct Ownership Interest | Jul 25, 2007 | 100% |
| Edna S Buffington-Price | Corporate Director | Mar 1, 2022 | |
| QHG of Fort Wayne Company LLC | 5% Or Greater Indirect Ownership Interest | Nov 30, 2014 | 42.45% |
| Lutheran Health Network of Indiana LLC | 5% Or Greater Indirect Ownership Interest | Nov 30, 2014 | 38.05% |
| Christopher G Cobb | Corporate Officer | Apr 1, 2017 | |
| CHS Community Health Systems Inc | 5% Or Greater Indirect Ownership Interest | Jul 25, 2007 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- General Practice Physician
- Fort Wayne, IN
- NPI 1619918026
5% Or Greater Indirect Ownership Interest
Facilities with the same owner 122
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Bluffton Regional Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Bluffton, IN
- NPI 1356839591
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Bluffton Regional Medical Center
- General Acute Care Hospital
- Bluffton, IN
- NPI 1376594366
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Dukes Memorial Hospital
- Critical Access Hospital
- Peru, IN
- NPI 1619920949
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Dukes Memorial Hospital
- Medicare Defined Swing Bed Hospital Unit
- Peru, IN
- NPI 1992749691
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Dupont Hospital
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1538110556
CHS Community Health Systems Inc, Community Health Systems Inc, DHFW Holdings LLC, Hma-Tri Holdings LLC, QHG of Fort Wayne Company LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Maple Heights Behavioral Health
- Psychiatric Hospital
- Fort Wayne, IN
- NPI 1932843117
Lutheran Health Network of Indiana LLC
-
dba Lutheran Hospital of Indiana
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
CHS Community Health Systems Inc, Community Health Systems Inc, DHFW Holdings LLC, Hma-Tri Holdings LLC, Lutheran Health Network of Indiana LLC, QHG of Fort Wayne Company LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Northwest Health- Starke
- Rural Acute Care Hospital
- Knox, IN
- NPI 1679948319
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Knox Family Medical Center
- Rural Health Clinic/Center
- Knox, IN
- NPI 1770936965
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Northwest Health-La Porte
- General Acute Care Hospital
- La Porte, IN
- NPI 1750746285
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba The Orthopaedic Hospital of Lutheran Health Network
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1174706576
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Lutheran Health Network of Indiana LLC, QHG of Fort Wayne Company LLC, Tennyson Holdings LLC, Triad Healthcare LLC
-
dba Northwest Health-Porter
- Rehabilitation Hospital Unit
- Portage, IN
- NPI 1154571180
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
Subparts reporting this organization as parent 6
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
dba Lutheran Downtown Hospital
- Rehabilitation Hospital Unit
- Fort Wayne, IN
- NPI 1033163407
-
dba St. Joseph Hospital Gero
- Psychiatric Hospital Unit
- Fort Wayne, IN
- NPI 1578517231
-
dba Stellhorn Freestanding Emergency Dept
- Emergency Care Clinic/Center
- Fort Wayne, IN
- NPI 1699670604
-
dba Transitional Care Unit of St Joseph
- Skilled Nursing Facility
- Fort Wayne, IN
- NPI 1740234111
-
dba St. Joseph Hospital Home Health Care
- Home Health Agency
- Fort Wayne, IN
- NPI 1104870583
-
dba Lutheran Downtown Hospital
- Medicare Defined Swing Bed Hospital Unit
- Fort Wayne, IN
- NPI 1538812946
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Fort Wayne, IN
- NPI 1922063189
-
- Internal Medicine Physician
- Irvine, CA
- NPI 1366883068
-
- Family Medicine Physician
- Orange, CA
- NPI 1659397792
-
- Diagnostic Radiology Physician
- Rancho Cucamonga, CA
- NPI 1568435717
Affiliated clinicians 145
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1902960966
Hospital
-
- Sports Medicine (Family Medicine) Physician
- Fort Wayne, IN
- NPI 1821521394
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638316800000",
"number": "1023060472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15819 COLLECTION CENTER DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606930158",
"telephone_number": "260-425-3000",
"fax_number": "260-425-3222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 VAN BUREN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468023697",
"telephone_number": "260-425-3000",
"fax_number": "260-425-3222"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. JOSEPH HEALTH SYSTEM, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-16",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A",
"authorized_official_last_name": "LALOR",
"authorized_official_first_name": "PAULA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
"authorized_official_telephone_number": "629-215-3953"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "IN",
"license": "05-005043-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lutheran Downtown Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Wayne, IN
- St Joseph Health System LLC (St. Joseph Hospital Gero)
- St Joseph Health System LLC (Stellhorn Freestanding Emergency Dept)
- St Joseph Health System LLC (Transitional Care Unit of St Joseph)
- St Joseph Medical Group Inc
- St. Joseph Health System LLC (St. Joseph Hospital Home Health Care)
- St. Joseph Health System, LLC (Lutheran Downtown Hospital)
- St. Joseph Township EMS
- St. Vincent Hospital and Health Care Center, Inc. (St. Vincent Pediatric Subspecialties)
- Jeff S Stachera, LMHC, MS ED
- Brent A Stachler, LMFT, MAC, MS ED
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.