Active NPI
Iom Health System LP
Doing business as Lutheran Hospital of Indiana
- General Acute Care Hospital
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 05-005016-1
- Legal business name
- IOM HEALTH SYSTEM LP
- Doing business as
- Lutheran Hospital of Indiana
- Practice address
- 7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 435-7001
- Fax
- (260) 435-7632
- NPI assigned
- May 15, 2006
- Last updated
- Jul 24, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | ||
| General Acute Care Hospital | 282N00000X | 05-005016-1 | IN | Primary |
| Air Ambulance | 3416A0800X | NU |
Addresses
Primary practice location
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-7001
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100379740A | Medicaid | IN | |
| 100268460A | Medicaid | IN |
Other names 1
- Lutheran Hospital of Indiana
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030220000021 | IN | Part A Provider - Hospital | 9537078027 | Practice locations: Fort Wayne, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1306897335. Details of each certification follow.
Hospital certification: CCN 150017
- Legal name
- IOM HEALTH SYSTEM LP
- Doing business as
- LUTHERAN HOSPITAL OF INDIANA
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Dec 2, 2004
- Beds
- 396
- Ownership / control type
- Private (for profit)
- Organization structure
- Partnership
- Incorporated
- Sep 26, 1995 in IN
- Enrollment address
- 7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Hospital subgroups
- Acute care
Care Compare: Hospital
Medicare Care Compare- Listed as
- Lutheran Hospital of Indiana
- 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
- Lutheran Senior Health
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Lutheran Hospital
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Fort Wayne, IN
- NPI 1124157961
-
dba Lutheran Hospital of Indiana OP Pharmacy
- Community/Retail Pharmacy
- Fort Wayne, IN
- NPI 1063565695
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 2
Organizations listed as members of this organization in the National Provider Directory.
-
dba The Orthopaedic Hospital of Lutheran Health Network
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1174706576
Member Of
-
- Ambulatory Surgical Clinic/Center
- Fort Wayne, IN
- NPI 1073561841
Member Of
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 27, 2012 | |
| 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 | ||
| 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% |
| Lorie L Ailor | W-2 Managing Employee | Jul 15, 2024 | |
| 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 | Sep 4, 2014 | 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 | Nov 1, 2007 | 100% |
| Lutheran Health Network Investors LLC | General Partnership Interest | Aug 25, 2014 | 98% |
| 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 | 40.46% |
| 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 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
-
dba Northwest Health-Porter
- General Acute Care Hospital
- Valparaiso, IN
- NPI 1215151154
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
Practitioners & affiliated clinicians
Practitioners 6
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
- Indianapolis, IN
- NPI 1659722460
-
- Physical Medicine & Rehabilitation Physician
- Rancho Mirage, CA
- NPI 1619133444
Interventional Pain Medicine
-
- Surgical Critical Care Physician
- Moreno Valley, CA
- NPI 1174834055
-
- Trauma Surgery Physician
- Detroit, MI
- NPI 1790166494
-
- Diagnostic Radiology Physician
- Rancho Cucamonga, CA
- NPI 1568435717
Affiliated clinicians 776
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1690156800000",
"number": "1306897335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7950 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-435-7001",
"fax_number": "260-435-7632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-435-7001",
"fax_number": "260-435-7632"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IOM HEALTH SYSTEM LP",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-15",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"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": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "IN",
"license": "05-005016-1",
"primary": true
},
{
"code": "3416A0800X",
"taxonomy_group": "",
"desc": "Ambulance, Air Transport",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100379740A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100268460A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lutheran Hospital of Indiana",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Wayne, IN
- Interdisciplinary Diagnostic & Evaluation Center, Inc.
- Interdisciplinary Diagnostic and Evaluation Center, Inc.
- Interventional Pain Consultants, LLC
- Intrepid Insights, LLC
- Iom Health System LP (Lutheran Hospital)
- Iom Health System LP (The Imaging Center of Lutheran Hospital)
- Iom Health System LP (Lutheran Hospital of Indiana-Gero psych unit)
- Iom Health Systems, LP (Lutheran Hospital of Indiana OP Pharmacy)
- Taylor Robert Ipsen, DO
- Iq Laboratories Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.