NPIMap

Organization Active NPI

Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • General Acute Care Hospital
  • Plymouth, IN
National Provider Identifier
1174571129
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
05-005070-1 Issued in IN
Legal business name
SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC
Practice address
1915 Lake Ave
Plymouth, IN 46563-9366
Phone
(574) 948-4000
Fax
(574) 948-5454
NPI assigned
May 4, 2006
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Christopher James Karam
Title
President
Phone
(574) 335-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 05-005070-1 IN Primary

Addresses

Primary practice location

1915 Lake Ave
Plymouth, IN 46563-9366

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031017000033 IN Part A Provider - Hospital 9537071337 Practice locations: Plymouth, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174571129. Details of each certification follow.

Hospital certification: CCN 150076

Legal name
SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC
Doing business as
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 23, 2003
Beds
58
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
1915 Lake Ave
Plymouth, IN 46563-9366
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Saint Joseph Regional Medical Center - PlymouthCCN 150076 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Saint Joseph Regional M3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christopher Karam Individual Contracted Managing EmployeePresident Jan 1, 2017
Corporate DirectorBoard Member Jan 1, 2017
James Foster Individual Corporate DirectorBoard Member Apr 21, 2022
Shannon Cermak Individual Corporate DirectorBoard Member Jan 1, 2026
Melissa Lukasick Individual Corporate OfficerTreasurer Jan 1, 2025
Jonathan Geise Individual Corporate DirectorBoard Member Jan 1, 2026
Marion Fulce Individual Corporate DirectorBoard Member Jan 1, 2025
Robert L Sink Individual Contracted Managing EmployeeVP of Finance Apr 21, 2022
Corporate OfficerAssistant Treasurer Jan 1, 2025
Craig B Miller Individual Corporate DirectorBoard Member Jan 1, 2017
W-2 Managing EmployeePhysician Jan 1, 2017
Jeffrey Mathis Individual Corporate OfficerSecretary Apr 21, 2022
Rodolfo Monterrosa Individual Corporate Officer Apr 21, 2022
Corporate DirectorBoard Member Apr 21, 2022
Paula M Toth-Russell Individual Corporate DirectorBoard Member Apr 21, 2022
W-2 Managing EmployeePhysician Jan 1, 2017
Jacqueline Wright Individual Corporate DirectorBoard Member Jan 1, 2019
Saint Joseph Regional Medical Center Inc Organization, Mishawaka, IN Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 2, 2020 100%
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest May 1, 2000 100%
Chris Rowland Individual Corporate DirectorBoard Member Apr 21, 2022
Dana Neer Individual Corporate DirectorBoard Member Jan 1, 2017

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 157

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 157

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

Affiliated clinicians 241

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 241

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1174571129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 LAKE AVE",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465639366",
            "telephone_number": "574-948-4000",
            "fax_number": "574-948-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "KARAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-335-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "05-005070-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

Verify at the official NPI Registry.