Active NPI
St Mary'S Medical Center of Evansville, Inc
- Podiatrist
- Evansville, IN
National Provider Identifier
1093028201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- ST MARY'S MEDICAL CENTER OF EVANSVILLE, INC
- Practice address
- 3801 Bellemeade Ave
Ste 110
Evansville, IN 47714-0100 - Phone
- (812) 485-8390
- Fax
- (812) 485-4679
- NPI assigned
- Jul 16, 2010
- Organization subpart
- Yes
- Parent organization
- ST MARY'S MEDICAL CENTER OF EVANSVILLE, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John T Gallagher, MD
- Title
- Sr Vice President and Cmo
- Phone
- (812) 485-4000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | |||
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
3801 Bellemeade Ave
Ste 110
Evansville, IN 47714-0100
Mailing address
PO Box 717
Evansville, IN 47705-0717
Phone (812) 471-1591
Other names 1
- St Mary's Podiatry Clinic
National Provider Directory
National Provider Directory- Tax ID family
- St Marys Med Ctr
- Part of
- St Marys Med Ctr
Other organizations with this tax ID 23
Organizations that report the same tax identification number in the National Provider Directory.
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-
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-
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-
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-
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- NPI 1720115264
-
- Physical Therapy Clinic/Center
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-
- Pediatric Dentistry
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-
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Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Occupational Medicine Clinic/Center
- Evansville, IN
- NPI 1144434473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279756800000",
"number": "1093028201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 717",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477050717",
"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": "3801 BELLEMEADE AVE",
"address_2": "STE 110",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140100",
"telephone_number": "812-485-8390",
"fax_number": "812-485-4679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST MARY'S MEDICAL CENTER OF EVANSVILLE, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST MARY'S MEDICAL CENTER OF EVANSVILLE, INC",
"enumeration_date": "2010-07-16",
"last_updated": "2010-07-22",
"status": "A",
"authorized_official_last_name": "GALLAGHER",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "SR VICE PRESIDENT AND CMO",
"authorized_official_telephone_number": "812-485-4000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "St Mary's Podiatry Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.