FIVE STAR RESIDENCES OF FORT WAYNE
NPI 1841365434
Assisted Living Facility in Fort Wayne, IN

Q: What is Five Star Quality Care - Obx Operator, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 21, 2006CLIA 15D2149009 · Waiver

2601 COVINGTON COMMONS DRIVE, FORT WAYNE, IN 46804(260) 432-1932(260) 432-7740 Get Directions Write a Review

NPPES record last updated: June 23, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Five Star Residences Of Fort Wayne NPPES

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

FIVE STAR RESIDENCES OF FORT WAYNE (NPI 1841365434) is a healthcare organization registered as an assisted living facility in Fort Wayne, Indiana and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2028 and lists Katherine E Potter, President & Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1841365434

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameFIVE STAR QUALITY CARE - OBX OPERATOR, LLC

Location Address2601 COVINGTON COMMONS DRIVEFort Wayne, IN 46804

Mailing Address400 Centre StreetNewton, MA 02458 · (617) 796-8387 · Fax (617) 796-8385

Phone(260) 432-1932

Fax(260) 432-7740

Organization SubpartYes

Authorized OfficialKatherine E PotterPresident & Chief Executive Officer · (617) 796-8387

Enumeration DateNovember 21, 2006

Last NPPES UpdateJune 23, 2020

NPPES CertifiedJune 23, 2020

✔ NPI 1841365434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

2601 COVINGTON COMMONS DRIVE, Fort Wayne, IN 46804

Open in Google Maps ↗

Other Names 1

Doing Business AsFive Star Residences Of Fort Wayne

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 15D2149009

Five Star Residences Of Fort Wayne · Fort Wayne, IN

Active · expires May 22, 2028

CLIA Number15D2149009

Laboratory TypeAssisted Living Facility

Certificate Effective DateMay 23, 2026

Certificate Expiration DateMay 22, 2028

Laboratory DirectorNikki Rogers

Laboratory Phone(260) 432-1932

Laboratory LocationFive Star Residences Of Fort Wayne2601 Covington Commons Drive, Fort Wayne, IN 46804

CLIA data matches this NPI record on: Address 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 Five Star Quality Care - Obx Operator, LLC's NPI number?

The NPI number for Five Star Quality Care - Obx Operator, LLC is 1841365434. It was assigned to this organization in the NPPES registry on November 21, 2006. The provider is doing business as Five Star Residences Of Fort Wayne.

Where is Five Star Quality Care - Obx Operator, LLC located?

Five Star Quality Care - Obx Operator, LLC is located at 2601 Covington Commons Drive, Fort Wayne, IN 46804. The listed phone number is (260) 432-1932.

What is Five Star Quality Care - Obx Operator, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Five Star Quality Care - Obx Operator, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2149009) is associated with this NPI, valid through May 22, 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 Five Star Quality Care - Obx Operator, LLC was last updated on June 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.