VIBRA HOSPITAL OF FORT WAYNE, LLC (NPI# 1174673636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174673636 |
| Entity Type | Organization |
| Organization Name | VIBRA HOSPITAL OF FORT WAYNE, LLC |
| Other Organization Name | VIBRA HOSPITAL OF FORT WAYNE |
| Practice Address |
2200 Randallia Dr 5th Floor Fort Wayne IN 46805-4638 |
| Mailing Address |
5 East River Park Place E #460 Fresno CA 93720-1560 |
| Practice Telephone | 2603992900 |
| Practice Fax Number | 2603992958 |
| Mailing Telephone | 5598922500 |
| Mailing Fax Number | 5598922442 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2018-12-14 |
| Authorized Official Name | MR. CLINT T. FEGAN (SEC/TREAS) |
| Authorized Official Telephone | 7175915700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 100121321 | IN | Hospitals |
| Other Name | Type Code |
|---|---|
| Vibra Hospital of Fort Wayne | Doing Business As Name - Organization |
| Street Address |
2200 RANDALLIA DR 5TH FLOOR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508471 | Matthew Paul Ziccardi | Clinical Neuropsychologist | 2200 Randallia Dr, Fort Wayne, IN 46805 | 2005-06-20 |
| 1891308896 | Cameron Buzzard | Physical Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-08-28 |
| 1558985945 | Morgan Taylor Hilbert | Pharmacist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-06-02 |
| 1952941908 | Lydia Hentz | Counselor | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-01-07 |
| 1326683228 | Nicole Marie Gaunt | Social Worker | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-11-14 |
| 1205490877 | Elisha Lynn Handshoe | Physical Medicine & Rehabilitation | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-29 |
| 1154884898 | Monique Brissette | Speech-Language Pathologist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-10 |
| 1649733411 | Clarissa Burkett | Physical Therapy Assistant | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| 1740743533 | Ross Tyler Nelson | Physical Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| 1295298982 | Jennifer Ferguson | Occupational Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825140 | Select Specialty Hospital - Fort Wayne Inc | Long Term Care Hospital | 700 Broadway, 7th Fl East, Fort Wayne, IN 46802-1402 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215341391 | Indiana University Health Inc. | Long Term Care Hospital | 550 University Blvd Rm 3145, Indianapolis, IN 46202-5149 | 2014-06-17 |
| 1336499599 | Gregg Scott Shepherd | Long Term Care Hospital | 1075 W Cr 300 North, New Castle, IN 47362 | 2012-09-14 |
| 1174710750 | Physicians Hospital, LLC | Long Term Care Hospital | 1625 E Jefferson Blvd, Mishawaka, IN 46545-7103 | 2007-09-27 |
| 1871613398 | Northern Indiana Health Care System | Long Term Care Hospital | 45 E Miller Rd, La Fontaine, IN 46940-9292 | 2007-03-29 |
| 1104991447 | Deanna Lynne Harrington | Long Term Care Hospital | 3025 W Sycamore St, Kokomo, IN 46901-4176 | 2006-11-22 |
| 1558446021 | Kindred Hospitals Limited Partnership | Long Term Care Hospital | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2006-10-25 |
| 1417032996 | Transitional Hospitals Corporation of Indiana, Inc. | Long Term Care Hospital | 607 Greenwood Springs Drive, Greenwood, IN 46143-1407 | 2006-10-25 |
| 1114972502 | St. Vincent Seton Specialty Hospital, Inc. | Long Term Care Hospital | 8050 Township Line Road, Indianapolis, IN 46260-1902 | 2006-05-23 |
| 1063414886 | Regency Hospital of Northwest Indiana, LLC | Long Term Care Hospital | 4321 Fir St, 4th Floor, East Chicago, IN 46312-3049 | 2005-08-11 |
| 1720087620 | Select Specialty Hospital - Indianapolis Inc | Long Term Care Hospital | 898 E Main St, Greenwood, IN 46143-1407 | 2005-07-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.