Deaconess Specialty Physicians Inc

Organization Active NPI Orthopaedic Surgery Physician · Jasper, IN

NPI 1124819388 · NPPES record last updated May 15, 2025

Key facts

NPI
1124819388
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
Legal business name
DEACONESS SPECIALTY PHYSICIANS INC
Practice address
695 2ND St
Jasper, IN 47546-3240
Phone
(812) 996-5950
Fax
(812) 996-5951
NPI assigned
May 15, 2025
Organization subpart
No

Authorized official

Name
Cheryl Annette Wathen
Title
Cfo
Phone
(812) 450-3296

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

Corporate family (same tax ID) 40

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

View all 40

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180702001637 IN Part B Supplier - Clinic/Group Practice 0244595205 Receives reassigned benefits from 283 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newburgh, IN; Washington, IN; Vincennes, IN; Santa Claus, IN; Princeton, IN; Linton, IN; Jasper, IN; Evansville, IN…

National Provider Directory

Tax ID family
Deaconess Specialty Physicians Inc (41 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

695 2ND St
Jasper, IN 47546-3240

Mailing address

PO Box 632111
Cincinnati, OH 45263-2111
Phone (812) 450-6879

Other providers in Jasper, IN

All providers in Jasper, IN · Orthopaedic Surgery Physician in Indiana

Sources for this page

Verify at the official NPI Registry.