NPIMap

Organization Active NPI

Indiana Regional Medical Center

  • Psychiatric Hospital Unit
  • Indiana, PA
National Provider Identifier
1801889969
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
INDIANA REGIONAL MEDICAL CENTER
Practice address
145 Irmc Dr
Indiana, PA 15701-3673
Phone
(724) 357-7404
Fax
(724) 357-7414
NPI assigned
Aug 24, 2005
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Mr. Michael F Ickowski, CPA, MBA
Title
Chief Financial Officer
Phone
(724) 357-7008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

145 Irmc Dr
Indiana, PA 15701-3673

Mailing address

835 Hospital Rd
PO Box 788
Indiana, PA 15701-3629
Phone (724) 357-7008

Other practice location 1

835 Hospital Rd
Behavioral Health Services
Indiana, PA 15701-3629
Phone (724) 357-7008

Other identifiers 2

IdentifierTypeStateIssuer
001354OtherPAHIGHMARK
1007713530013MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081212000480 PA Part A Provider - Hospital 6800791187 Practice locations: Indiana, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801889969. Details of each certification follow.

Hospital certification: CCN 39S173

Legal name
INDIANA REGIONAL MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jan 16, 1913 in PA
Enrollment address
145 Irmc Dr
Indiana, PA 15701-3673
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Indiana Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
James R Martin Individual Corporate DirectorTreasurer Nov 1, 2020
Christina Lubold Individual Corporate DirectorDirector Jan 1, 2022
Mary Krauland Individual Corporate DirectorDirector Jul 1, 2024
James Kinneer Individual W-2 Managing EmployeeChief Human Resource Officer Nov 28, 2017 14.28%
Nathan Kovalchick Individual Corporate OfficerChairman Jan 1, 2022
Wendell S Davis Individual Corporate DirectorDirector Jul 1, 2024
Pennsylvania Mountains Care Network Organization, Indiana, PA Corporation, Non-profit Operational/Managerial Control Nov 1, 2020 100%
Other Nov 1, 2020 100%
Laurie Kuzneski Individual Corporate DirectorVice Chairman Nov 1, 2020
Michael F Ickowski Sr Individual W-2 Managing EmployeeChief Financial Officer Jun 26, 2023 12.5%
Mark Richards Individual W-2 Managing EmployeeChief Growth Officer Nov 28, 2017 14.28%
April L Miller Individual W-2 Managing EmployeeExecutive Director Revenue Cycle Apr 8, 2024
Sandra Luttner Individual Operational/Managerial ControlDirector of Finance Nov 2, 2009
T Clark Simpson Individual Corporate DirectorDirector Nov 1, 2020
Frank Roberts Individual Corporate OfficerSecretary Nov 1, 2020
Todd Brice Individual Corporate DirectorBoard Member Jan 1, 2022
Mark Volovic Individual W-2 Managing EmployeeChief Information Officer May 1, 2017 14.28%
Rebecca Stapleton Individual Corporate OfficerDirector Jan 1, 2022
Indiana Regional Medical Center Organization, Indiana, PA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 1998 100%
Wendy Haislip Individual W-2 Managing EmployeeChief Nursing Officer Oct 21, 2019 14.28%
Richard K Neff Individual W-2 Managing EmployeeChief Medical Officer Oct 26, 2020 14.28%
Chad R Shaffer Individual Corporate DirectorDirector Jul 1, 2024
Hilliary Creely Individual Corporate DirectorDirector Nov 1, 2020
Stephen a Wolfe Individual Corporate OfficerCeo Jul 1, 2015
Corporate DirectorBoard Member Jul 1, 2015
W-2 Managing EmployeePresident and Ceo Feb 11, 1999 14.28%
T Michael Price Individual Corporate OfficerDirector Nov 1, 2020
Russell a Drozdiak Individual Corporate DirectorDirector Nov 1, 2020

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Indiana Regional Medical CenterIndiana, PA, CCN 39T173 Hospital Operational/Managerial Control Aug 24, 2005
Visiting Nurse Association of Indiana CountyIndiana, PA, CCN 397097 Home health agency 5% Or Greater Direct Ownership Interest (49%) Jan 1, 2021
Vna Family HospiceIndiana, PA, CCN 391511A Hospice 5% Or Greater Direct Ownership Interest (49%) Jan 1, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 13

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

View all 13

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1801889969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 HOSPITAL RD",
            "address_2": "PO BOX 788",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013629",
            "telephone_number": "724-357-7008",
            "fax_number": "724-357-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 IRMC DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013673",
            "telephone_number": "724-357-7404",
            "fax_number": "724-357-7414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Hospital Rd",
            "address_2": "Behavioral Health Services",
            "address_purpose": "LOCATION",
            "city": "Indiana",
            "state": "PA",
            "postal_code": "157013629",
            "country_code": "US",
            "telephone_number": "724-357-7008",
            "fax_number": "724-357-7414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDIANA REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "ICKOWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "724-357-7008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA, MBA"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001354",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007713530013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.