Deaconess Kentucky Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEACONESS KENTUCKY CLINIC INC

Practice address

1305 N Elm St
Henderson, KY 42420-2783

Phone

(812) 450-6815

Fax

(812) 450-6822

NPI assigned

Jul 30, 2026

Last updated

Oct 22, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kyle Dillman

Title

Director

Phone

(812) 450-7399

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1785369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792627200000",
    "number": "1275456105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632817",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202783",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS KENTUCKY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-30",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A",
        "authorized_official_last_name": "DILLMAN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-450-7399"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deaconess Hospital, Inc. (Deaconess Cross Pointe - Henderson)
• Deaconess Kentucky Specialty Clinic Inc
• Deaconess Speciality Physicians, Inc
• Deaconess Speciality Physicians, Inc
• Deaconess Speciality Physicians, Inc
• Deaconess Specialty Physicians Inc

• Family Medicine Physician in Henderson, KY
• Providers in Henderson, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; 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.