ADAMS COUNTY MEMORIAL HOSPITAL


Address: 6701 South Anthony Boulevard, Fort Wayne, IN 46816-2035
Phone: 2604470800

ADAMS COUNTY MEMORIAL HOSPITAL (NPI# 1073554200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073554200
Entity Type Organization
Organization Name ADAMS COUNTY MEMORIAL HOSPITAL
Other Organization Name LUTHERAN LIFE VILLAGES (ANTHONY)
Practice Address 6701 South Anthony Boulevard
Fort Wayne
IN 46816-2035
Mailing Address 1100 Mercer Ave
Decatur
IN 46733-2303
Practice Telephone 2604470800
Practice Fax Number 2604477369
Mailing Telephone 2607242145
Mailing Fax Number 2607283852
Enumeration Date 2006-06-09
Last Update Date 2014-09-29
Authorized Official Name MR. DANE WHEELER (CFO/TREASURER)
Authorized Official Telephone 2607242145
Authorized Official Credential CPA
Is Organization Subpart Y
Parent Organization Name ADAMS COUNTY MEMORIAL HOSPITAL

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 313M00000X Nursing Facility/Intermediate Care Facility 050002831 IN Nursing & Custodial Care Facilities
N 310400000X Assisted Living Facility Nursing & Custodial Care Facilities
Y 314000000X Skilled Nursing Facility 050002831 IN Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IN 201235720A 05
RCAP 0220 01
IN 100275020 05

Other Provider/Organization Names

Other Name Type Code
Lutheran Life Villages (Anthony) Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1891031480 Adams County Memorial Hospital Skilled Nursing Facility 1350 West Main Street, Berne, IN 46711-1794 2012-12-31
1134493281 Adams County Memorial Hospital Nursing Facility/Intermediate Care Facility 9802 Coldwater Road, Fort Wayne, IN 46825 2012-03-06
1982729604 Adams County Memorial Hospital Nursing Facility/Intermediate Care Facility 6996 S Us 421, Versailles, IN 47042-9390 2007-03-20
1760519268 Adams County Memorial Hospital Skilled Nursing Facility 12011 Whittern Rd, Monroeville, IN 46773-9126 2007-02-28
1356476154 Adams County Memorial Hospital Skilled Nursing Facility 1300 Mercer Ave, Decatur, IN 46733-2407 2007-02-22
1477699460 Adams County Memorial Hospital Skilled Nursing Facility 200 West Fourth Dtreet, Oaktown, IN 47561-8081 2007-01-29
1235205816 Adams County Memorial Hospital Skilled Nursing Facility 520 W 9th Street, Jasper, IN 47546-2711 2006-11-27
1659454148 Adams County Memorial Hospital Skilled Nursing Facility 9325 N. Crawford Streeet, Knightsville, IN 47857-0170 2006-10-20
1366531907 Adams County Memorial Hospital Assisted Living Facility 400 Caylor Boulevard, Bluffton, IN 46714-8805 2006-10-12
1821185356 Adams County Memorial Hospital Skilled Nursing Facility 17475 Dugdale Dr, South Bend, IN 46635-1545 2006-10-06

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities ADAMS COUNTY MEMORIAL HOSPITAL 1100 Mercer Ave, Decatur, IN 46733-2303

Office Location

Street Address 6701 SOUTH ANTHONY BOULEVARD
City FORT WAYNE
State IN
Zip Code 46816-2035

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841769270 Brian Bernard Conaway Occupational Therapist 7125 S Hanna St, Fort Wayne, IN 46816 2018-11-14
1073006938 Fort Wayne Aal Lp Assisted Living Facility 7125 S Hanna Street, Fort Wayne, IN 46816 2018-06-14
1811282064 Connisha Sanders Occupational Therapy Assistant 8309, Bridgeway Cir Apt 3a, Fort Wayne, IN 46816 2011-06-16
1144239609 James J Bohlin Dentist 7524 South Anthony Blvd., Fort Wayne, IN 46816 2006-08-05
1578594537 K Mart Corp Pharmacy 7530 S Anthony Blvd, Fort Wayne, IN 46816 2006-07-06
1720540503 Jill Ann Woodward Occupational Therapy Assistant 7125 S Hanna St, Fort Wayne, IN 46816 2019-04-02
1639163884 Patrice C Ellingson Optometrist 1515 E Paulding Rd, Fort Wayne, IN 46816 2005-09-02
1114140134 Jon D. Ingleman Dentist 223 E Tillman Rd, Fort Wayne, IN 46816-1016 2007-04-10
1538189063 Yoder/rahrig Family Dentistry Dentist 333 E Tillman Rd, Fort Wayne, IN 46816-1017 2006-07-20
1619997137 Gerald J. Rahrig Dentist 333 E Tillman Rd, Fort Wayne, IN 46816-1017 2006-07-20
Find all providers in zip 46816

Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023487592 Lindsey Marie Fuller Skilled Nursing Facility 10603 Wild Flower Pl, Fort Wayne, IN 46845-1687 2015-09-15
1336548353 Pulaski Memorial Hospital Skilled Nursing Facility 6050 S Cr 800 E-92, Fort Wayne, IN 46814-9201 2014-08-14
1154766459 Major Hospital Skilled Nursing Facility 10445 Dupont Oaks Blvd, Fort Wayne, IN 46845-8792 2013-05-01
1326310400 Riverview Hospital Skilled Nursing Facility 4111 Park Place Drive, Fort Wayne, IN 46845-8793 2012-02-03
1710280888 Kelly Michelle Wood Skilled Nursing Facility 8528 Killeen Run, Fort Wayne, IN 46835-9657 2010-12-13
1194940205 Recovery Health Services, Inc Skilled Nursing Facility 12101 Lima Rd, Fort Wayne, IN 46818-8903 2007-04-16
1871623041 Henry County Memorial Hospital Skilled Nursing Facility 1400 Medical Park Dr, Fort Wayne, IN 46825-5832 2007-03-06
1740315878 Henry County Memorial Hospital Skilled Nursing Facility 5700 Wilkie Dr, Fort Wayne, IN 46804-1662 2007-02-22
1326180803 Woodlawn Hospital Skilled Nursing Facility 3136 Goeglein Rd, Fort Wayne, IN 46815-6685 2007-02-13
1528130432 Indiana Health & Rehabilitation Center Skilled Nursing Facility 3811 Parnell Ave, Fort Wayne, IN 46805-1409 2006-11-15
Find all providers in FORT WAYNE

Competitor

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City FORT WAYNE
Zip Code 46816

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Dataset Information

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.

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