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

NPI Status: Active since July 18, 2015

Contact Information

2121 LAKE AVE
FORT WAYNE, IN
ZIP 46805
Phone: (260) 426-5431

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  • Organization
  • Clinic/Center
  • VA
  • CLIA Number: 15D0988541
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 05-22-2026

About VA NORTHERN INDIANA HEALTH CARE SYSTEM

This page provides the complete NPI Profile along with additional information for Va Northern Indiana Health Care System, a provider established in Fort Wayne, Indiana operating as a Clinic/center, focusing in va . The healthcare provider is registered in the NPI registry with number 1386028330 assigned on July 2015. The practitioner's primary taxonomy code is 261QV0200X with license number 03233198 (OH). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Richard Hayes (Credentialing Specialist)

NPI
1386028330
Provider Name
VA NORTHERN INDIANA HEALTH CARE SYSTEM
Entity Type
Organization
Location Address
2121 LAKE AVE FORT WAYNE, IN 46805
Location Phone
(260) 426-5431
Mailing Address
4374 COUNTY ROAD 233 CLYDE, OH 43410
Mailing Phone
(419) 463-0025
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-18-2015
Last Update Date
07-18-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center VA

Taxonomy Code
261QV0200X
Type
Ambulatory Health Care Facilities
License No.
03233198
License State
OH

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RICHARD HAYES

Authorized Official Title
CREDENTIALING SPECIALIST
Authorized Official Phone
(260) 426-5431

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D0988541
Facility Type
Hospital
Certificate Effective Date
June 29, 2001
Certificate Expiration Date
May 22, 2026
Laboratory Director
SUSAN M. SORENSEN
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Va Northern Indiana Health Care System on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1386028330, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
6
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 8 → 16 → 7 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 6 + 6 + 0 + 2 + 1 + 6 + 3 + 6 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1386028330.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Dentist (General Practice)
2121 LAKE AVE
FORT WAYNE, IN 46805
Social Worker (Clinical)
2121 LAKE AVE, VA-NIHCS
FT WAYNE, IN 46805
Physician Assistant
2121 LAKE AVE
FORT WAYNE, IN 46805
Audiologist
2121 LAKE AVE
FORT WAYNE, IN 46805
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Surgery
2121 LAKE AVE, VETERANS AFFAIRS MEDICAL CENTER
FORT WAYNE, IN 46805
Internal Medicine (Cardiovascular Disease)
2121 LAKE AVE
FORT WAYNE, IN 46805
Audiologist
2121 LAKE AVE, AUDIOLOGY (126)
FORT WAYNE, IN 46805
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Pharmacist (Pharmacotherapy)
2121 LAKE AVE, (119A)
FORT WAYNE, IN 46805
Internal Medicine (Rheumatology)
2121 LAKE AVE, DEPARTMENT OF VETERANS AFFAIRS (11)
FORT WAYNE, IN 46805
Optometrist
2121 LAKE AVE
FORT WAYNE, IN 46805
Occupational Therapist
2121 LAKE AVE
FORT WAYNE, IN 46805
Social Worker
2121 LAKE AVE
FORT WAYNE, IN 46805
Specialist
2121 LAKE AVE
FORT WAYNE, IN 46805
Internal Medicine
2121 LAKE AVE
FORT WAYNE, IN 46805
Nurse Practitioner
2121 LAKE AVE
FORT WAYNE, IN 46805
Internal Medicine
2121 LAKE AVE
FORT WAYNE, IN 46805
Internal Medicine
2121 LAKE AVE
FORT WAYNE, IN 46805

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386028330, enumerated as an "organization" on July 18, 2015.

The provider is located at 2121 LAKE AVE FORT WAYNE, IN 46805 and the phone number is (260) 426-5431.

Clinic/Center with taxonomy code 261QV0200X and a focus in VA.