NPIMap

Organization Active NPI

Deaconess Hospital, Inc.

Doing business as Deaconess Home Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Jasper, IN
National Provider Identifier
1114760501
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DEACONESS HOSPITAL, INC.
Doing business as
Deaconess Home Medical Equipment
Practice address
213 S US Highway 231 Ste C
Jasper, IN 47546-3244
Phone
(812) 996-0620
Fax
(812) 996-5704
NPI assigned
Jun 14, 2024
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DEACONESS HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Cheryl Annette Wathen
Title
Senior Vice President
Phone
(812) 450-3296

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Oxygen Equipment & Supplies (DME) 332BX2000X NU

Addresses

Primary practice location

213 S US Highway 231 Ste C
Jasper, IN 47546-3244

Mailing address

701 Garfield Ave
Evansville, IN 47710-1771
Phone (812) 450-4673

Other names 1

  • Deaconess Home Medical Equipment Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422000073 IN DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 9032021431 Practice locations: Jasper, IN

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Deaconess Hospital, Inc.213 S US Highway 231, Jasper, IN 47546-3279(812) 996-5970 Commodes, Urinals, Bedpans|Hospital Beds (Electric)|Hospital Beds (Manual)|Neuromuscular Elect Stimulators (NMES)/Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Ultraviolet Light Devices and/or Supplies|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard M… Accepts assignmentParticipating since Apr 24, 2018

National Provider Directory

National Provider Directory
Tax ID family
John C Betancourt MD46 organizations share this tax ID, including this one
Part of
John C Betancourt MD

Other organizations with this tax ID 45

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

View all 45

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Encompass Health Deaconess Rehabilitation HospitalNewburgh, IN, CCN 153025 Hospital 5% Or Greater Direct Ownership Interest (27.5%) May 9, 1997
The Women's HospitalNewburgh, IN, CCN 150149 Hospital 5% Or Greater Direct Ownership Interest (50%) Nov 9, 1998
Deaconess Home Health, LLCEvansville, IN, CCN 157565 Home health agency 5% Or Greater Direct Ownership Interest (50%) Nov 2, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1114760501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GARFIELD AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101771",
            "telephone_number": "812-450-4673",
            "fax_number": "812-450-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S US HIGHWAY 231 STE C",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463244",
            "telephone_number": "812-996-0620",
            "fax_number": "812-996-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEACONESS HOSPITAL, INC.",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.