Individual provider Active NPI

William M Vickers, MD

  • Anesthesiology Physician
  • Evansville, IN
National Provider Identifier
1053309302
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01043252A Issued in IN
Practice address
21 SE Third Street
Suite 500
Evansville, IN 47708-1421
Phone
(812) 473-0181
Fax
(812) 473-5822
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01043252A IN Primary

Addresses

Primary practice location

21 SE Third Street
Suite 500
Evansville, IN 47708-1421

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other identifiers 1

IdentifierTypeStateIssuer
200002730MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000797 IN Practitioner - Anesthesiology 0345301347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kentucky College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Hospital, Inc Anesthesiology CurrentSince Jan 31, 2025 Accepting new patients
Deaconess Hospital Inc CurrentSince Jan 31, 2025 Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

520 Mary St
Ste 130
Evansville, IN 47710
Phone (812) 250-0100

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4133 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 250-0200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1053309302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SE THIRD STREET",
            "address_2": "SUITE 500",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081421",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01043252A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.