Deaconess Clinic, Inc
Organization Active NPI Family Medicine Physician · Evansville, IN
NPI 1013274471 · NPPES record last updated Oct 14, 2020
Key facts
- NPI
- 1013274471
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DEACONESS CLINIC, INC
- Practice address
- 4506 1St Ave
Evansville, IN 47710-3624 - Phone
- (812) 428-6161
- Fax
- (812) 421-2883
- NPI assigned
- Apr 23, 2012
- Organization subpart
- No
Authorized official
- Name
- Cheryl A Wathen
- Title
- Cfo
- Phone
- (812) 450-3296
Practitioners 52
-
Phillip M Adams, MD
-
Dean E. Beckman, M.D.
-
Jared Cerny, MD
-
Cristina Maria Chenoweth, NP-C
-
Nell M Clay, NP
-
Donna J Duncan, NP
-
Zersha Fischer, D.O.
-
Sarah M Hardin, NP
-
Michael R Hobson, MD
-
Katie M Hopf, NP
-
Leslie S Hubert, NP
-
Tracy Joan Kinner, N.P.
-
Adam Joseph Klem, MD
-
Lynniece A Kocher, D.O.
-
Katie M Lawless, APRN
-
Megan E Missaggia, M.D.
-
Rehan Rahman, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080922000145 | IN | Part B Supplier - Clinic/Group Practice | 3375610116 |
Receives reassigned benefits from 477 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Pediatrics Physician |
208000000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
4506 1St Ave
Evansville, IN 47710-3624
Mailing address
PO Box 1510
Evansville, IN 47706-1510
Phone (812) 428-6161
Other names
- Deaconess Clinic I
Other providers in Evansville, IN
- Deaconess Clinic Inc
- Deaconess Clinic Inc.
- Deaconess Clinic Inc.
- Deaconess Clinic Inc.
- Deaconess Clinic Inc.
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
All providers in Evansville, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.