INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC (NPI# 1184703704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184703704 |
| Entity Type | Organization |
| Organization Name | INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC |
| Other Organization Name | LA PORTE REGIONAL HEALTH SYSTEM INC |
| Practice Address |
1007 Lincolnway La Porte IN 46352-0250 |
| Practice Telephone | 2193261234 |
| Practice Fax Number | 2193255403 |
| Mailing Telephone | 2193261234 |
| Mailing Fax Number | 2193255403 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2013-09-16 |
| NPI Deactivation Date | 07/17/2007 |
| NPI Reactivation Date | 2007-08-07 |
| Authorized Official Name | MR. G THOR THORDARSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 2193262555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273Y00000X | Rehabilitation Unit | 09-005006-1 | IN | Hospital Units |
| Y | 273Y00000X | Rehabilitation Unit | 11-005006-1 | IN | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100269110 | 05 | |
| IN | 200714310 | 05 | |
| IN | 700339 | 05 | |
| IN | ANTHEM | 000000097783 | 01 |
| IN | 100269120 | 05 |
| Other Name | Type Code |
|---|---|
| La Porte Regional Health System Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952480154 | Indiana University Health La Porte Hospital Inc | Home Health | 901 South Woodland Avenue, Michigan City, IN 46360-5672 | 2006-11-06 |
| 1992884878 | Indiana University Health La Porte Hospital Inc | Clinic/Center | 400 Teegarden, La Porte, IN 46350-3175 | 2006-11-03 |
| 1447336938 | Indiana University Health La Porte Hospital Inc | Hospice Care, Community Based | 901 South Woodland Ave, Michigan City, IN 46360-5672 | 2006-10-27 |
| 1386880060 | Indiana University Health La Porte Hospital Inc | Clinic/Center | 400 Teegarden St, La Porte, IN 46350-3175 | 2008-12-30 |
| 1386822989 | Indiana University Health La Porte Hospital Inc | General Acute Care Hospital | 1007 Lincolnway, La Porte, IN 46350-3201 | 2008-02-06 |
| 1467531335 | Indiana University Health La Porte Hospital Inc | Clinic/Center | 311 Boyd Blvd, La Porte, IN 46350-3965 | 2006-11-03 |
| 1558446393 | Indiana University Health La Porte Hospital Inc | Skilled Nursing Facility | 1007 Lincolnway, La Porte, IN 46350-3201 | 2006-10-26 |
| 1144277971 | Indiana University Health La Porte Hospital Inc | General Acute Care Hospital | 1007 Lincolnway, La Porte, IN 46350-3201 | 2006-05-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC. | Po Box 250, Laporte, IN 46352 |
| Street Address |
1007 LINCOLNWAY |
| City | LA PORTE |
| State | IN |
| Zip Code | 46352-0250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699304907 | Katherine Elizabeth Davis | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-04-07 |
| 1245864057 | Mitchell Steven Molenda | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-03-02 |
| 1295381580 | Samantha Burrows | Specialist/Technologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-13 |
| 1447805072 | Jill Renee Oscarson | Speech-Language Pathologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-09 |
| 1922663863 | Ashley Lysle Miller | Physical Medicine & Rehabilitation | 1007 Lincolnway, La Porte, IN 46350-3290 | 2019-05-07 |
| 1780249946 | Kyleigh Fife | Physical Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-05-03 |
| 1629542204 | Krista Marie Kerby | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-01-16 |
| 1538659560 | Stephanie Maris Kadish | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2018-05-15 |
| 1346760873 | Cary Lynn Malstaff | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-06-26 |
| 1134652340 | Pathology Associates of Northwest Indiana Inc | Pathology | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-04-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467781617 | Scipio Township Volunteer Fire Department | Voluntary or Charitable | 1105 W. 250 South, La Porte, IN 46352-1991 | 2009-12-17 |
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831554369 | La Porte Hospital Company LLC | Rehabilitation Unit | 1007 Lincolnway, La Porte, IN 46350-3201 | 2015-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619317062 | Melanie Jane Shanks | Rehabilitation Unit | 4523 Fairlawn Pass, Fort Wayne, IN 46815-6039 | 2013-06-30 |
| 1013962984 | Saint Joseph Regional Medical Center South Bend Campus Inc | Rehabilitation Unit | 60205 Bodnar Blvd, Mishawaka, IN 46544-9342 | 2006-05-22 |
| 1609873124 | Indianapolis Osteopathic Hospital, Inc | Rehabilitation Unit | 3630 Guion Road, Indianapolis, IN 46222-1616 | 2005-06-30 |
| 1417320979 | Indiana University Health Inc | Rehabilitation Unit | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2015-11-05 |
| 1558788927 | Laura Sanders | Rehabilitation Unit | 2339 S State Road 135, Greenwood, IN 46143-4800 | 2014-03-24 |
| 1811324775 | Progressivehealth of Indiana | Rehabilitation Unit | 150 N Rosenberger Ave, Evansville, IN 47712-6503 | 2013-10-08 |
| 1043579238 | St Vincent Hospital and Health Care Center Inc | Rehabilitation Unit | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2012-05-09 |
| 1225356389 | St. Vincent Health | Rehabilitation Unit | 8227 Northwest Blvd, Indianapolis, IN 46278-1387 | 2010-05-13 |
| 1528297207 | Cni Starke LLC | Rehabilitation Unit | 102 E Culver Rd, Knox, IN 46534-2216 | 2009-07-02 |
| 1962657379 | Knox Indiana Hospital Company LLC | Rehabilitation Unit | 102 E Culver Rd, Knox, IN 46534-2216 | 2008-11-26 |
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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.