NPIMap

Organization Active NPI

St Mary's Medical Center of Evansville, Inc

Doing business as St Mary's Podiatry Clinic

  • Podiatrist
  • Evansville, IN
National Provider Identifier
1093028201
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ST MARY'S MEDICAL CENTER OF EVANSVILLE, INC
Doing business as
St Mary's Podiatry Clinic
Practice address
3801 Bellemeade Ave
Ste 110
Evansville, IN 47714-0100
Phone
(812) 485-8390
Fax
(812) 485-4679
NPI assigned
Jul 16, 2010
Last updated
Jul 22, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ST MARY'S MEDICAL CENTER OF EVANSVILLE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Marys Medical Center Inc24 organizations share this tax ID, including this one
Part of
St Marys Medical Center Inc

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

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.

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.

Verify at the official NPI Registry.