Active NPI
Ignite Medical Resort Crown Point, LLC
- Skilled Nursing Facility
- Crown Point, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- IGNITE MEDICAL RESORT CROWN POINT, LLC
- Practice address
- 1555 S Main St
Crown Point, IN 46307-0114 - Phone
- (219) 323-8700
- NPI assigned
- Sep 5, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy Fields
- Title
- Manager
- Phone
- (833) 944-6483
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1555 S Main St
Crown Point, IN 46307-0114
Mailing address
1550 N Northwest Hwy Ste 430
Park Ridge, IL 60068-1461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231214001352 | IN | Part A Provider - Skilled Nursing Facility | 8325497480 | Practice locations: Crown Point, IN |
Skilled nursing facility certification: CCN 155835
- Legal name
- IGNITE MEDICAL RESORT CROWN POINT LLC
- Doing business as
- IGNITE MEDICAL RESORT CROWN POINT LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Jul 13, 2015
- Last certification
- Jan 13, 2025
- Beds
- 106 (70 certified)
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Enrollment address
- 1555 S Main St
Crown Point, IN 46307-0114 - Nursing home name
- IGNITE MEDICAL RESORT CROWN POINT LLC
- Affiliated entity
- IGNITE MEDICAL RESORTS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Ignite Medical Resort Crown Point LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- Jul 13, 2015
- Medicare certification status
- Active
- Certified beds
- 70
- Chain
- Ignite Medical Resorts
National Provider Directory
National Provider DirectoryLocations
1550 N Northwest Hwy
Ste 430
Park Ridge, IL 60068
Ownership & related parties
All disclosed owners & managing parties 41
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 |
|---|---|---|---|
| Israel Family Investment Trust | Indirect Ownership Interest | Nov 1, 2023 | 5% |
| John T McFarlane | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Robert Petty | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Ignite-Villa in Holdco LLC | Direct Ownership Interest | Nov 1, 2023 | 50% |
| Jim White | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Indirect Ownership Interest | Nov 1, 2023 | 2% | |
| Alexander a Stemer | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Barry Carr | Operational/Managerial Control | Nov 1, 2023 | |
| Managing Control - Governing Body | Nov 1, 2023 | ||
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 16% | |
| Luxe Staffing LLC | Adp of the SNF | Nov 1, 2023 | |
| Shawna Rainey | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Aug 1, 2024 | 1% | |
| Jared Carr | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Indirect Ownership Interest | Jan 1, 2025 | 3% | |
| Indirect Ownership Interest | Nov 1, 2023 | 4% | |
| Anc Indiana Opco LLC | Indirect Ownership Interest | Nov 1, 2023 | 20% |
| Marc L Rose | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Ignite Crown Point JV LLC | Direct Ownership Interest | Nov 1, 2023 | 50% |
| Adp of the SNF | Dec 27, 2023 | ||
| Benjamin Israel | Managing Control - Governing Body | Nov 1, 2023 | |
| David Hartman | Indirect Ownership Interest | Nov 1, 2023 | 7% |
| Indirect Ownership Interest | Nov 1, 2023 | 3% | |
| Spark Therapy LLC | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Marnie Davisson | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Israel Investment TR | Indirect Ownership Interest | Nov 1, 2023 | 5% |
| Prestige Worldwide Crown Point LLC | Indirect Ownership Interest | Nov 1, 2023 | 10% |
| Karen Gillis | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Ryan Gobst | Indirect Ownership Interest | Nov 1, 2023 | 2% |
| Ignite Team Partners LLC | Operational/Managerial Control | Nov 1, 2023 | 100% |
| Adp of the SNF | Nov 1, 2023 | ||
| Blue Pearl Financial LLC | Indirect Ownership Interest | Nov 1, 2023 | 16% |
| Drake Louis Enterprise, LLC | Indirect Ownership Interest | Nov 1, 2023 | 7% |
| Stern Family Investment TR | Indirect Ownership Interest | Nov 1, 2023 | 10% |
| Menachem Berger | Managing Control - Governing Body | Nov 1, 2023 | |
| Ignite Post Acute Solutions LLC | Indirect Ownership Interest | Nov 1, 2023 | 20% |
| Gold Pearl, LLC | Indirect Ownership Interest | Nov 1, 2023 | 4% |
| Timothy Fields | Operational/Managerial Control | Nov 1, 2023 | |
| Managing Control - Governing Body | Nov 1, 2023 | ||
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 20% | |
| Mathew Thengil | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% | |
| Mark Hartman | Indirect Ownership Interest | Nov 1, 2023 | 4% |
| Indirect Ownership Interest | Nov 1, 2023 | 4% | |
| Berger Fam TR Ua 06252014 | Indirect Ownership Interest | Nov 1, 2023 | 10% |
| Nicole Jablonski | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Indirect Ownership Interest | Nov 1, 2023 | 1% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Infectious Disease Physician
- Munster, IN
- NPI 1861451429
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 22
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Chesterton, IN
- NPI 1326895053
Ignite Team Partners LLC
-
- Skilled Nursing Facility
- Dyer, IN
- NPI 1427834597
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Batavia, IL
- NPI 1942197686
Ignite Team Partners LLC
-
- Skilled Nursing Facility
- Hanover Park, IL
- NPI 1932899689
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Bartlesville, OK
- NPI 1023648383
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Kansas City, MO
- NPI 1649808577
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- El Paso, TX
- NPI 1083434336
Ignite Team Partners LLC
-
- Skilled Nursing Facility
- Fort Worth, TX
- NPI 1659031268
Ignite Team Partners LLC, Spark Therapy LLC
-
dba Ignite Medical Resort Blue Springs
- Skilled Nursing Facility
- Blue Springs, MO
- NPI 1609492719
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Kansas City, MO
- NPI 1790263440
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Katy, TX
- NPI 1841930575
Ignite Team Partners LLC, Spark Therapy LLC
-
- Skilled Nursing Facility
- Norman, OK
- NPI 1689204943
Ignite Team Partners LLC, Spark Therapy LLC
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Crown Point, IN
- NPI 1316943137
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693872000000",
"number": "1801672977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 N NORTHWEST HWY STE 430",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 S MAIN ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463070114",
"telephone_number": "219-323-8700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IGNITE MEDICAL RESORT CROWN POINT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-05",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A",
"authorized_official_last_name": "FIELDS",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "833-944-6483"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.