NPIMap

Organization Active NPI

Indiana University Health Jay, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Portland, IN
National Provider Identifier
1669991279
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
INDIANA UNIVERSITY HEALTH JAY, INC.
Practice address
500 W Votaw St
Portland, IN 47371-1322
Phone
(260) 726-7131
NPI assigned
Sep 14, 2017
Last updated
Sep 14, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIANA UNIVERSITY HEALTH JAY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Authorized official

Name
Jonathan Vanator
Title
Cfo
Phone
(765) 741-2891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

500 W Votaw St
Portland, IN 47371-1322

Mailing address

950 N Meridian St Ste 1200
Indianapolis, IN 46204-1011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180316000234 IN Part A Provider - Critical Access Hospital 1355602483 Practice locations: Portland, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669991279. Details of each certification follow.

Hospital certification: CCN 15Z320

Legal name
INDIANA UNIVERSITY HEALTH JAY INC
Doing business as
IU HEALTH JAY
Organization structure
OtherNon-profit
Enrollment address
500 W Votaw St
Portland, IN 47371-1322
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Indiana University Health Jay Inc4 organizations share this tax ID, including this one
Part of
Indiana University Health Jay Inc

Other organizations with this tax ID 3

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
John Rhea Individual Corporate DirectorBoard of Directors Mar 18, 2021
Christina Schemenaur Individual Corporate OfficerCno/Coo Apr 25, 2022
Terry Bailey Individual Corporate DirectorBoard of Directors Mar 18, 2021
Dea Bell Individual Corporate DirectorBoard of Directors May 18, 2023
Liesel Delamater Individual Corporate Officer Feb 1, 2026
W-2 Managing Employee Feb 1, 2026
Operational/Managerial Control Feb 1, 2026
Donald Engel Individual Corporate DirectorBoard of Directors May 16, 2024
Charles R Routh Individual Corporate DirectorBoard of Directors Mar 18, 2021
Indiana University Health Inc Organization, Indianapolis, IN Corporation, Non-profit Operational/Managerial Control Mar 1, 2018
Kevin Woodgett Individual Corporate DirectorBoard of Directors May 16, 2024
Patrick a Cleary Individual Corporate DirectorBoard of Directors Mar 18, 2021
Geoffrey S Mearns Individual Corporate DirectorBoard of Directors Mar 18, 2021
Wilbur Davis Individual Corporate DirectorBoard of Directors Mar 18, 2021
Derron Bishop Individual Corporate DirectorBoard of Directors Mar 18, 2021
Michelle a Altobella Individual Corporate OfficerSecretary Mar 1, 2018
Peter M Voss Individual Corporate DirectorBoard of Directors Mar 18, 2021
William W Hinkle Individual Corporate DirectorBoard of Directors Mar 1, 2018
Joan Victoria Castor Individual Corporate DirectorBoard of Directors Mar 18, 2021
Michael Fisher Individual Corporate DirectorBoard of Directors Mar 18, 2021
Daniel Borgenheimer Individual Corporate DirectorChairman Board of Directors Mar 18, 2021
Michael Craig Individual Corporate OfficerCfo Jul 1, 2024
Operational/Managerial ControlCfo Jul 1, 2024
Eric S Westergren Individual Corporate DirectorBoard of Directors May 15, 2025

Owners & managing parties with NPI records 24

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

View all 24

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1669991279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N MERIDIAN ST STE 1200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-726-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH JAY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA UNIVERSITY HEALTH JAY, INC.",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "VANATOR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-741-2891"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, IN

Sources for this page

Verify at the official NPI Registry.