NPIMap

Organization Active NPI

Hendricks County Hospital

Doing business as Life Care Center of Fort Wayne

  • Skilled Nursing Facility
  • Fort Wayne, IN
National Provider Identifier
1700833670
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
05000167 Issued in IN
Legal business name
HENDRICKS COUNTY HOSPITAL
Doing business as
Life Care Center of Fort Wayne
Practice address
1649 Spy Run Ave
Fort Wayne, IN 46805-4032
Phone
(260) 422-8520
Fax
(260) 422-9345
NPI assigned
May 27, 2006
Last updated
Sep 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Authorized official

Name
Cindy Cross
Title
Assist Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 05000167 IN Primary

Addresses

Primary practice location

1649 Spy Run Ave
Fort Wayne, IN 46805-4032

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
100273740MedicaidIN

Other names 1

  • Life Care Center of Fort Wayne Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180918001586 IN Part A Provider - Skilled Nursing Facility 4880505528 Practice locations: Fort Wayne, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700833670. Details of each certification follow.

Skilled nursing facility certification: CCN 155266

Legal name
HENDRICKS COUNTY HOSPITAL
Doing business as
LIFE CARE CENTER OF FT WAYNE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1985
Last certification
Apr 24, 2025
Beds
115
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America
Organization structure
OtherNon-profit
Enrollment address
1649 Spy Run Ave
Fort Wayne, IN 46805-4032
Nursing home name
LIFE CARE CENTER OF FORT WAYNE
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of Fort WayneCCN 155266 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11583.6 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
15D0723705Life Care Center of Fort Wayne1649 Spy Run Avenue, Fort Wayne, IN 46805Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Health Tracks Immediate110 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

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

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.

NameRoleSinceShare
Forrest L Preston Individual Operational/Managerial Control Aug 1, 2018
Adp of the SNF Aug 1, 2018
Terry Henry Individual Operational/Managerial Control Aug 1, 2018
Holly Gentry Individual Operational/Managerial Control Aug 1, 2018
Adp of the SNF Aug 1, 2018
Todd Fletcher Individual Operational/Managerial Control Aug 1, 2018
Timothy a Whicker Individual Managing Control - Governing BodyBoard Member Jan 12, 2022
Trustee of the SNF Jan 12, 2022
Deanna M Fenoughty Individual Corporate OfficerPresident and Ceo Jul 10, 2023
Operational/Managerial Control Jul 10, 2023
Aubrey Preston Individual Operational/Managerial Control Mar 6, 2025
Thomas P Van Den Driessche Individual Operational/Managerial Control May 1, 2021
Adp of the SNF May 1, 2021
John Waite Individual Managing Control - Governing BodyBoard Member Aug 1, 2020
Trustee of the SNF Aug 1, 2020
Joan E Thurmond Individual Operational/Managerial Control Aug 1, 2018
Hendricks County Hospital Organization, Danville, IN Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2018 100%
Adp of the SNF Feb 26, 2025
Richard Swanker Individual Operational/Managerial Control Aug 1, 2018
Mark Edward Gentry Individual Managing Control - Governing BodyBoard Member Jan 12, 2022
Trustee of the SNF Jan 12, 2022
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, For-profit, Chain home office Operational/Managerial Control Aug 1, 2018
Adp of the SNF Mar 14, 2025
Fort Wayne Operations LLC Organization, Cleveland, TN LLC, Management services company, For-profit Operational/Managerial Control Aug 1, 2018 100%
Adp of the SNF Aug 1, 2018
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Aug 1, 2018
Tyler Starkey Individual Managing Control - Governing BodyBoard Member Aug 1, 2020
Trustee of the SNF Aug 1, 2020
Lisa M Lay Individual Operational/Managerial Control Aug 1, 2018
James Ziegler Individual Operational/Managerial Control Aug 1, 2018

Owners & managing parties with NPI records 28

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

View all 28

All facility ownership & control disclosures 46

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hendricks Regional HealthDanville, IN, CCN 150005 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Laporte Care CenterLa Porte, IN, CCN 155062 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Churchman Care CenterIndianapolis, IN, CCN 155138 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Bloomington Care CenterBloomington, IN, CCN 155278 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Brookview Care CenterIndianapolis, IN, CCN 155076 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Sycamore Village Care CenterKokomo, IN, CCN 155367 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Valparaiso Care CenterValparaiso, IN, CCN 155137 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Twelfth Street Care CenterMishawaka, IN, CCN 155109 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Merrillville Care CenterMerrillville, IN, CCN 155362 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Woodbridge Care CenterEvansville, IN, CCN 155390 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Portage Care CenterPortage, IN, CCN 155187 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Lincoln Hills Care CenterTell City, IN, CCN 155384 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Golden Rule Care CenterRichmond, IN, CCN 155264 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Elkhart Care CenterElkhart, IN, CCN 155685 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Brandywine Care CenterGreenfield, IN, CCN 155120 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Brentwood Care CenterEvansville, IN, CCN 155248 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Terrace Care CenterLa Porte, IN, CCN 155136 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Knox Care CenterKnox, IN, CCN 155686 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Woodlands Care CenterNewburgh, IN, CCN 155252 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Hamilton Trace of FishersFishers, IN, CCN 155793 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 15, 2013
Brickyard Healthcare - Fountainview Care CenterMishawaka, IN, CCN 155178 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brickyard Healthcare - Muncie Care CenterMuncie, IN, CCN 155687 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012
Brownsburg Health Care CenterBrownsburg, IN, CCN 155206 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2013
Castleton Health Care CenterIndianapolis, IN, CCN 155245 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2013
Brickyard Healthcare - Petersburg Care CenterPetersburg, IN, CCN 155375 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2014
Brickyard Healthcare - Richmond Care CenterRichmond, IN, CCN 155157 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2014
Brickyard Healthcare - Willow Springs Care CenterIndianapolis, IN, CCN 155834 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 10, 2015
The Waters of LebanonLebanon, IN, CCN 155211 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 15, 2017
Westside Retirement VillageIndianapolis, IN, CCN 155606 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Aug 1, 2018
Feb 24, 2025
Mitchell ManorMitchell, IN, CCN 155324 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Aug 1, 2018
Feb 25, 2025
Heritage HealthcareWest Lafayette, IN, CCN 155402 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Sep 1, 2018
Feb 26, 2025
Life Care Center of the WillowsValparaiso, IN, CCN 155158 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 1, 2018
Feb 24, 2025
Hammond-Whiting Care CenterWhiting, IN, CCN 155423 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 1, 2018
Feb 27, 2025
Parkview Care CenterEvansville, IN, CCN 155348 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 1, 2018
Feb 24, 2025
Life Care Center of Michigan CityMichigan City, IN, CCN 155344 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 1, 2018
Feb 25, 2025
Life Care Center of LagrangeLagrange, IN, CCN 155343 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 1, 2018
Feb 27, 2025
The Lane HouseCrawfordsville, IN, CCN 155477 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Sep 1, 2012
Feb 20, 2025
The WoodlandsMuncie, IN, CCN 155229 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2018
Feb 26, 2025
Life Care Center of ValparaisoValparaiso, IN, CCN 155331 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2018
Feb 21, 2025
Green Valley Care CenterNew Albany, IN, CCN 155070 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2018
Feb 28, 2025
Life Care Center of RochesterRochester, IN, CCN 155379 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2018
Feb 27, 2025
Rensselaer Care CenterRensselaer, IN, CCN 155287 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Nov 1, 2018
Feb 27, 2025
Byron Health CenterFort Wayne, IN, CCN 155364 Skilled nursing facility Direct Ownership Interest (100%) Aug 1, 2020
Hickory Creek at SunsetGreencastle, IN, CCN 155565 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2022
May 7, 2025
Suburban Home Health, LLCNoblesville, IN, CCN 157092 Home health agency 5% Or Greater Indirect Ownership Interest (12.82%) Sep 3, 2024
Suburban HospiceNoblesville, IN, CCN 151547 Hospice 5% Or Greater Indirect Ownership Interest (12.82%) Nov 1, 2024

Facilities with the same owner 224

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

View all 224

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1700833670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 SPY RUN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054032",
            "telephone_number": "260-422-8520",
            "fax_number": "260-422-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ASSIST SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "05000167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100273740",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Sainte Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Fort Wayne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Care Center 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.