Deaconess Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEACONESS CLINIC, INC

Doing business as

Deaconess Clinic I

Practice address

4015 Gateway Blvd
Newburgh, IN 47630-8925

Phone

(812) 858-9400

Fax

(812) 858-9571

NPI assigned

Aug 18, 2008

Last updated

Sep 16, 2020By 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

Cheryl A Wathen

Title

Cfo

Phone

(812) 450-3296

Specialties & licenses 15

Addresses

Other identifiers 1

Other names 1

• Deaconess Clinic I Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phillip J Anderson

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1427542083
  NPD
• Courtney Bender, DO

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1538455027
  NPD
• Andrew Benton, M.D.

  • Family Medicine Physician
  • Greenwood, IN
  • NPI 1336553858
  NPD
• John C Bizal, M.D.

  • Otolaryngology Physician
  • Evansville, IN
  • NPI 1518939966
  NPD
• Megan Marie Blankenberger, AUDIOLOGIST

  • Audiologist
  • Newburgh, IN
  • NPI 1548798523
  NPD
• Laura L Burke, NP

  • Family Nurse Practitioner
  • Newburgh, IN
  • NPI 1245672484
  NPD
• Emily R Burkett, NP

  • Nurse Practitioner
  • Evansville, IN
  • NPI 1912315466
  NPD
• Katelyn M Cannon, NP

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1538899224
  NPD
• Chris E Chacko, MD

  • Otolaryngology Physician
  • Evansville, IN
  • NPI 1679731665
  NPD
• Jessica M Cox, DO

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1487184156
  NPD
• Kathleen Marie Dunn, NP

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1073024238
  NPD
• Kareem Maher El-Khodary, MD

  • Internal Medicine Physician
  • Newburgh, IN
  • NPI 1629607510
  NPD

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1306092689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-858-9400",
            "fax_number": "812-858-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308925",
            "telephone_number": "812-858-9400",
            "fax_number": "812-858-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200910700A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Clinic I",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deaconess Clinic I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deaconess Clinic Inc
• Deaconess Clinic Inc (Deaconess Clinic - MOB 6)
• Deaconess Clinic Inc (Deaconess Clinic I)
• Deaconess Clinic Inc. (Deaconess Clinic II)
• Deaconess Clinic, Inc (Deaconess Clinic I)
• Deaconess Clinic, Inc
• Deaconess Clinic, Inc (Deaconess Clinic II)
• Deaconess Clinic, Inc
• Deaconess Clinic, Inc (Deaconess Comp Center Gateway)
• Deaconess Clinic, Inc. (Deaconess Clinic - Wyntree)

• Family Medicine Physician in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.