NPIMap

Organization Active NPI

Indiana Health Centers, Inc

Doing business as IHC at Bendix Community Health Center

  • Federally Qualified Health Center (FQHC)
  • South Bend, IN
National Provider Identifier
1780065672
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INDIANA HEALTH CENTERS, INC
Doing business as
IHC at Bendix Community Health Center
Practice address
1010 N Bendix Dr
South Bend, IN 46628-1925
Phone
(574) 245-4984
Fax
(574) 245-4981
NPI assigned
Jun 16, 2015
Last updated
Mar 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Authorized official

Name
Mr. Tracy J Nagel
Title
Cfo
Phone
(317) 576-1335

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1010 N Bendix Dr
South Bend, IN 46628-1925

Mailing address

8003 Castleway Dr
Indianapolis, IN 46250-1946
Phone (317) 576-1335

Other names 1

  • IHC at Bendix Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150820011429 IN Part A Provider - Federally Qualified Health Center (FQHC) 3971599473 Practice locations: South Bend, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780065672. Details of each certification follow.

Federally qualified health center certification: CCN 151955

Legal name
INDIANA HEALTH CENTERS INC
Doing business as
IHC BENDIX COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 24, 2015
Last certification
Aug 24, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1010 N Bendix Dr
South Bend, IN 46628-1925

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Indiana Health Centers Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

8003 Castleway Dr
Indianapolis, IN 46250
Phone (317) 576-1335

1700 Dividend Dr
Logansport, IN 46947
Phone (574) 722-7407

415 E Madison St
South Bend, IN 46617
Phone (574) 283-1234

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Rebekah Price Individual Corporate DirectorBoard Member Feb 29, 2020
Brian P Kelly Individual Corporate DirectorBoard Member Sep 26, 2015
Earl H Lane Individual Corporate DirectorBoard Member Apr 10, 2011
Ann Lundy Individual Corporate OfficerCeo Jun 1, 2022
Michael D Busch Individual Corporate DirectorBoard Member Sep 24, 1966
Addison G Haynes Individual Corporate OfficerCmo Feb 4, 2026
W-2 Managing EmployeeCmo Feb 4, 2026
Nicole Meyer Individual Corporate DirectorBoard Member Aug 1, 2020
Tracy J Nagel Individual Corporate OfficerCfo Jun 2, 2008
W-2 Managing EmployeeCfo May 31, 2022
Tamara L Habegger Individual Corporate DirectorBoard Member Mar 28, 2015
David McDonald Individual Corporate DirectorBoard Member Sep 24, 2016
Ayotade Ojutalayo Individual Corporate DirectorBoard Member Oct 1, 2012
Maricela Navarro Individual Corporate DirectorBoard Member Aug 24, 2019
Andrea R Graham Individual Corporate DirectorBoard Member Jun 27, 2015
Bernard J Emkes Individual Corporate DirectorBoard Member Jun 4, 2003

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1780065672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CASTLEWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501946",
            "telephone_number": "317-576-1335",
            "fax_number": "317-576-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N BENDIX DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281925",
            "telephone_number": "574-245-4984",
            "fax_number": "574-245-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "NAGEL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "317-576-1335",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHC at Bendix Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IHC at Bendix Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.