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VA NORTHERN INDIANA HEALTH CARE SYSTEM
NPI 1386028330
Clinic/Center - VA in Fort Wayne, IN

Active since July 18, 2015
2121 LAKE AVE, FORT WAYNE, IN 46805(260) 426-5431 Get Directions Write a Review

NPPES record last updated: July 18, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Va Northern Indiana Health Care System NPPES

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

VA NORTHERN INDIANA HEALTH CARE SYSTEM (NPI 1386028330) is a healthcare organization registered as a va in Fort Wayne, Indiana and active in the NPI registry since July 2015. The organization lists Richard Hayes, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1386028330
Entity TypeOrganization
Primary Taxonomy261QV0200X
Legal Business NameVA NORTHERN INDIANA HEALTH CARE SYSTEM
Location Address2121 LAKE AVEFort Wayne, IN 46805-5100
Mailing Address4374 County Road 233Clyde, OH 43410-9750 · (419) 463-0025
Phone(260) 426-5431
Organization SubpartNo
Authorized OfficialRichard HayesCredentialing Specialist · (260) 426-5431
Enumeration DateJuly 18, 2015
✔ NPI 1386028330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · VAAmbulatory Health Care Facilities
Taxonomy Code261QV0200X
License✔ Licensed in OH · 03233198
2121 LAKE AVE, Fort Wayne, IN 46805
Open in Google Maps ↗

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 Accreditation 15D0988541

VA Northern Indiana Hcs-Fort Wayne · Fort Wayne, IN
Expired · May 22, 2026
CLIA Number15D0988541
Laboratory TypeHospital
Certificate Effective DateJune 29, 2001
Certificate Expiration DateMay 22, 2026
Laboratory DirectorSusan M. Sorensen
Laboratory Phone(219) 460-1422
Laboratory LocationVA Northern Indiana Hcs-Fort Wayne2121 Lake Ave Bldg 1 Rm 240-246, Fort Wayne, IN 46805
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SIMON JAMES DUNN LCSW
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. RICHARD ALLEN LOLKUS DDS
Dentist (General Practice)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 421-1045
MRS. SUSAN DIANE REUSSER LCSW
Social Worker (Clinical)
2121 LAKE AVE, VA-NIHCS
FT WAYNE, IN 46805
Allen County (260) 426-5431
LYNN VANDAME PAC
Physician Assistant
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
MRS. DAWN RENEE BEVERLY M.A., CCC-A
Audiologist
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
RITA A. WYNN LCSW
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. IAN H. COOK M.D.
Surgery
2121 LAKE AVE, VETERANS AFFAIRS MEDICAL CENTER
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. DANIEL E. SANTOS M.D.
Internal Medicine (Cardiovascular Disease)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431

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 VA Northern Indiana Health Care System's NPI number?

The NPI number for VA Northern Indiana Health Care System is 1386028330. It was assigned to this organization in the NPPES registry on July 18, 2015.

Where is VA Northern Indiana Health Care System located?

VA Northern Indiana Health Care System is located at 2121 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 426-5431.

What is VA Northern Indiana Health Care System's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in VA, with taxonomy code 261QV0200X.

When was this NPI record last updated?

The NPPES record for VA Northern Indiana Health Care System was last updated on July 18, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.