BAE SYSTEMS FORT WAYNE IN
NPI 1013500271
Clinic/Center - Occupational Medicine in Fort Wayne, IN

Q: What is Premise Health Of Indiana Medical PC's NPI number?

The NPI number for Premise Health Of Indiana Medical PC is 1013500271. It was assigned to this organization in the NPPES registry on February 18, 2021. The provider is doing business as Bae Systems Fort Wayne In.

Q: What is Premise Health Of Indiana Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Occupational Medicine, with taxonomy code 261QX0100X.

Active since February 18, 2021CLIA 15D2080384 · Waiver

4350 AIRPORT EXPRESSWAY, FORT WAYNE, IN 46509(260) 434-5053(260) 434-5413 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 25, 2022, Feb 18, 2021 (2 updates tracked since 2021).

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About Bae Systems Fort Wayne In NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAE SYSTEMS FORT WAYNE IN (NPI 1013500271) is a healthcare organization registered as an occupational medicine in Fort Wayne, Indiana and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through July 6, 2028 and lists Jon Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1013500271

Entity TypeOrganization

Primary Taxonomy261QX0100X

Legal Business NamePREMISE HEALTH OF INDIANA MEDICAL PC

Location Address4350 AIRPORT EXPRESSWAYFort Wayne, IN 46509

Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993

Phone(260) 434-5053

Fax(260) 434-5413

Organization SubpartNo

Authorized OfficialJon LeizmanPresident · (615) 468-6270

Enumeration DateFebruary 18, 2021

Last NPPES UpdateOctober 29, 20242 updates tracked since enumeration

NPPES CertifiedOctober 29, 2024

✔ NPI 1013500271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Occupational MedicineAmbulatory Health Care Facilities

Taxonomy Code261QX0100X

4350 AIRPORT EXPRESSWAY, Fort Wayne, IN 46509

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Other Names 1

Doing Business AsBae Systems Fort Wayne In

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2080384

Premise Health Of Indiana Medical, PC · Fort Wayne, IN

Active · expires Jul 6, 2028

CLIA Number15D2080384

Laboratory TypePhysician Office

Certificate Effective DateJuly 7, 2026

Certificate Expiration DateJuly 6, 2028

Laboratory DirectorJason Mckown

Laboratory Phone(260) 434-5053

Laboratory LocationPremise Health Of Indiana Medical, PC4250 Airport Expressway, Fwi, Fort Wayne, IN 46809

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of Indiana Medical PC's NPI number?

The NPI number for Premise Health Of Indiana Medical PC is 1013500271. It was assigned to this organization in the NPPES registry on February 18, 2021. The provider is doing business as Bae Systems Fort Wayne In.

Where is Premise Health Of Indiana Medical PC located?

Premise Health Of Indiana Medical PC is located at 4350 Airport Expressway, Fort Wayne, IN 46509. The listed phone number is (260) 434-5053.

What is Premise Health Of Indiana Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Occupational Medicine, with taxonomy code 261QX0100X.

Does Premise Health Of Indiana Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2080384) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Indiana Medical PC was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.