Active NPI
Warsaw Health System LLC
- Medicare Defined Swing Bed Hospital Unit
- Warsaw, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- Legal business name
- WARSAW HEALTH SYSTEM LLC
- Practice address
- 2101 Dubois Dr
Warsaw, IN 46580-3210 - Phone
- (574) 267-3200
- Fax
- (574) 372-7692
- NPI assigned
- Oct 30, 2020
- Organization subpart
- Yes
- Parent organization
- WARSAW HEALTH SYSTEM LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula Lalor
- Title
- Director/Delegated Official
- Phone
- (629) 215-3953
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Primary |
Addresses
Primary practice location
2101 Dubois Dr
Warsaw, IN 46580-3210
Mailing address
2101 Dubois Dr
Warsaw, IN 46580-3210
Phone (574) 267-3200
Other names 1
- Kosciusko Community 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 |
|---|---|---|---|---|
| O20201214000387 | IN | Part A Provider - Hospital | 1355259136 | Practice locations: Warsaw, IN |
Hospital certification: CCN 15U133
- Legal name
- WARSAW HEALTH SYSTEM LLC
- Doing business as
- LUTHERAN KOSCIUSKO HOSPITAL
- Organization structure
- LLC
- Incorporated
- Dec 31, 1998 in DE
- Enrollment address
- 2101 Dubois Dr
Warsaw, IN 46580-3210 - Hospital subgroups
- Swing-bed approved
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Part of
- Provident Family Healthcare
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
808 S Huntington St
Syracuse, IN 46567
Phone (219) 457-8585
1500 Provident Dr
Ste C
Warsaw, IN 46580
Phone (574) 372-3800
Ownership & related parties
All disclosed owners & managing parties 17
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 | Feb 27, 2012 | ||
| Nathaniel K Summar | Corporate Director | Jul 15, 2017 | |
| Benjamin C Fordham | Corporate Officer | Apr 1, 2017 | |
| Corporate Director | Apr 1, 2017 | ||
| Jae Lee Dale | W-2 Managing Employee | Oct 15, 2018 | |
| 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% |
| Frankfort Health Partner, Inc | 5% Or Greater Direct Ownership Interest | Sep 1, 2019 | 100% |
| Jason Kevin Johnson | Corporate Officer | Jan 6, 2020 | |
| Roman Gabriel Ottinger | Corporate Officer | Jan 6, 2020 | |
| 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, 2007 | 100% |
| Cheri S Kane | Corporate Director | Apr 1, 2017 | |
| Tim Lee Hingtgen | Corporate Officer | Jun 1, 2018 | |
| Corporate Director | Jun 1, 2018 | ||
| Christopher G Cobb | Corporate Officer | Apr 23, 2013 | |
| CHS Community Health Systems Inc | 5% Or Greater Indirect Ownership Interest | Jul 25, 2007 | 100% |
Facilities with the same owner 120
Facilities that share an organizational owner with 5% or greater ownership or operational control.
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-
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- Medicare Defined Swing Bed Hospital Unit
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- NPI 1992749691
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-
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- NPI 1538110556
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-
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- NPI 1306897335
CHS Community Health Systems Inc, Community Health Systems Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
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- Rural Acute Care Hospital
- Knox, IN
- NPI 1679948319
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-
- Rural Health Clinic/Center
- Knox, IN
- NPI 1770936965
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- General Acute Care Hospital
- La Porte, IN
- NPI 1750746285
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-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1174706576
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- Rehabilitation Hospital Unit
- Portage, IN
- NPI 1154571180
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-
- General Acute Care Hospital
- Valparaiso, IN
- NPI 1215151154
CHS Community Health Systems Inc, Community Health Systems Inc, Frankfort Health Partner, Inc, Hma-Tri Holdings LLC, Tennyson Holdings LLC, Triad Healthcare LLC
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Athletic Trainer
- Warsaw, IN
- NPI 1932461845
-
- Athletic Trainer
- Warsaw, IN
- NPI 1891095881
-
- Family Medicine Physician
- Milford, IN
- NPI 1477597094
-
- Internal Medicine Physician
- Appleton, WI
- NPI 1821011651
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1619049600000",
"number": "1679173306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 DUBOIS DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803210",
"telephone_number": "574-267-3200",
"fax_number": "574-372-7692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 DUBOIS DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465803210",
"telephone_number": "574-267-3200",
"fax_number": "574-372-7692"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WARSAW HEALTH SYSTEM LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WARSAW HEALTH SYSTEM LLC",
"enumeration_date": "2020-10-30",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A",
"authorized_official_last_name": "LALOR",
"authorized_official_first_name": "PAULA",
"authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
"authorized_official_telephone_number": "629-215-3953"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Kosciusko Community Hospital",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Kosciusko Community Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.