NPIMap

Organization Active NPI

Board of Trustees of Welborn Clinic

Doing business as Welborn Clinic Gateway Deaconess Riley

  • Allergy & Immunology Physician
  • Newburgh, IN
National Provider Identifier
1093901910
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
BOARD OF TRUSTEES OF WELBORN CLINIC
Doing business as
Welborn Clinic Gateway Deaconess Riley
Practice address
4133 Gateway Blvd
Suite 220
Newburgh, IN 47630-8950
Phone
(812) 426-9459
Fax
(812) 463-7888
NPI assigned
Sep 25, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
David D. Christeson, MD
Title
Ceo
Phone
(812) 426-9506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

4133 Gateway Blvd
Suite 220
Newburgh, IN 47630-8950

Mailing address

4133 Gateway Blvd.
Suite 220
Newburgh, IN 47630

Other names 1

  • Welborn Clinic Gateway Deaconess Riley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Board of Trustees of Welborn Clinic11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1093901910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 GATEWAY BLVD.",
            "address_2": "SUITE 220",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "47630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 GATEWAY BLVD",
            "address_2": "SUITE 220",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308950",
            "telephone_number": "812-426-9459",
            "fax_number": "812-463-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES OF WELBORN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "CHRISTESON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-426-9506",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welborn Clinic Gateway Deaconess Riley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.