St. Mary's Breast Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ST. MARY'S BREAST CENTER, LLC

Practice address

100 St Marys Epworth Xing Ste A500
Newburgh, IN 47630-9698

Phone

(812) 485-4437

Fax

(812) 485-6890

NPI assigned

May 15, 2014

Last updated

Feb 8, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

SETON HEALTHAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vickie Detroy

Title

Director

Phone

(812) 471-1591

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1033520713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477010138",
            "telephone_number": "812-471-1591",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING STE A500",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309698",
            "telephone_number": "812-485-4437",
            "fax_number": "812-485-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S BREAST CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SETON HEALTH",
        "enumeration_date": "2014-05-15",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "DETROY",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-471-1591"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Marys Health Inc (Ascension St. Vincent Evansville Breast Center)
• St Marys Health Inc (Ascension St. Vincent Evansville)
• St Marys Health Inc (Ascension St. Vincent Warrick EMS)
• St Marys Physicians Health Group LLC (Newburgh Primary Physicians)
• St. Mary's at Home Inc (St. Mary's Medical Equipment)
• St. Mary's Health, Inc (Ascension St. Vincent Evansville)
• St. Mary's Health, Inc. (Ascension St. Vincent Evansville Breast Center)
• St. Mary's Health, Inc. (Ascension St. Vincent Evansville Medical Equipment)
• Savannah Stammer, RBT
• Grover Starks, RBT

• Physical Therapist in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.