NPIMap

Individual provider Active NPI

Michael T Myers, MD

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1275600371
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01056009A Issued in IN
Practice address
8600 N Kentucky Ave
Evansville, IN 47725-6302
Phone
(812) 426-9565
Fax
(812) 426-9572
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01056009A IN Primary

Addresses

Primary practice location

8600 N Kentucky Ave
Evansville, IN 47725-6302

Mailing address

PO Box 3868
Evansville, IN 47737-3868
Phone (812) 426-9565

Other identifiers 3

IdentifierTypeStateIssuer
64046683OtherKYKY MEDICAID
000000218438OtherINANTHEM
200371090MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080924000615 IN Practitioner - Family Practice 2567539000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

4506 1St Ave
Evansville, IN 47710-3624
Phone (812) 428-6161

8600 N Kentucky Ave
Evansville, IN 47725-6302
Phone (812) 426-9565

Hospital & facility affiliations

  • Deaconess Home Health, LLC Home health agency, Evansville, IN, CCN 157565
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056
  • The Women'S Hospital Hospital, Newburgh, IN, CCN 150149
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01056009AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic, Inc Family Medicine Past Accepting new patients

Locations

8600 N Kentucky Ave
Evansville, IN 47725
Phone (812) 426-9565

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: mmyers2437@direct.deaconess.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1275600371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477373868",
            "telephone_number": "812-426-9565",
            "fax_number": "812-426-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 N KENTUCKY AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477256302",
            "telephone_number": "812-426-9565",
            "fax_number": "812-426-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01056009A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "64046683",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000218438",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200371090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.