NPIMap

Organization Active NPI

Rehab Hospital of Fort Wayne LLC

Doing business as Rehab Hospital of Fort Wayne

  • Rehabilitation Hospital
  • Fort Wayne, IN
National Provider Identifier
1649221680
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
06-006245-1 Issued in IN
Legal business name
REHAB HOSPITAL OF FORT WAYNE LLC
Doing business as
Rehab Hospital of Fort Wayne
Practice address
7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 435-6100
NPI assigned
May 15, 2006
Last updated
Sep 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
John Duggan
Title
VP
Phone
(717) 975-4503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 06-006245-1 IN Primary

Addresses

Primary practice location

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

4714 Gettysburg Rd
Legal
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other identifiers 2

IdentifierTypeStateIssuer
200097450AMedicaidIN
153030OtherINMEDICARE

Other names 1

  • Rehab Hospital of Fort Wayne Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030509000013 IN Part A Provider - Hospital 4082524723 Practice locations: Fort Wayne, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649221680. Details of each certification follow.

Hospital certification: CCN 153030

Legal name
REHAB HOSPITAL OF FORT WAYNE LLC
Doing business as
SELECT MEDICAL REHABILITATION HOSPITAL AT LUTHERAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Nov 22, 1993
Last certification
Jul 24, 2003
Beds
36
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Select Medical Rehabilitation Hospital at LutheranCCN 153030 · All quality measures
Ownership
For profit
Certified
Nov 22, 1993
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0882440Select Medical Rehabilitation Hospital at Lutheran7970 West Jefferson Boulevard, Fort Wayne, IN 46804Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7970 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2607

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Select Medical Corporation Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2023 100%
Operational/Managerial Control Sep 1, 2023 100%
Thomas Mullin Individual Corporate Officer Sep 5, 2025
Gregory Parrett Individual Corporate OfficerCeo Mar 11, 2024
W-2 Managing EmployeeCeo Mar 11, 2024
Operational/Managerial ControlCeo Mar 11, 2024
Intensiva Healthcare Corporation Organization, Mechanicsburg, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2023 70%
John Saich Individual Corporate Officer Sep 5, 2025
Robert Breighner Individual W-2 Managing EmployeeCompliance Officer Sep 5, 2025
Michael Malatesta Individual Corporate Officer Sep 5, 2025
Robert Kido Individual Corporate Officer Sep 5, 2025
John Duggan Individual Corporate Officer Sep 1, 2023
Corporate Director Sep 5, 2025
Lutheran Health Network of Indiana LLC Organization, Franklin, TN LLC 5% Or Greater Direct Ownership Interest Jul 1, 2022 30%

Facilities with the same owner 133

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

View all 133

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1757462400000",
    "number": "1649221680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7970 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-435-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB HOSPITAL OF FORT WAYNE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "IN",
            "license": "06-006245-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097450A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "153030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab Hospital of Fort Wayne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.