NPIMap

Organization Active NPI

Deaconess Clinic, Inc.

Doing business as Deaconess Clinic - DC at Work Berry Global

  • Clinic/Center
  • Evansville, IN
National Provider Identifier
1306492160
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DEACONESS CLINIC, INC.
Doing business as
Deaconess Clinic - DC at Work Berry Global
Practice address
315 N 1St Ave
Evansville, IN 47710-1218
Phone
(812) 450-4066
Fax
(812) 429-1523
NPI assigned
Aug 16, 2019
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

315 N 1St Ave
Evansville, IN 47710-1218

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

Other names 1

  • Deaconess Clinic - DC at Work Berry Global Doing business as

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2152013Deaconess Clinic at Work First Ave315 N First Ave, Evansville, IN 47710Certificate of waiverJul 31, 2026
15D2167747Deaconess Clinic at Work Berry Global315 N First Ave, Evansville, IN 47710Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Clinic100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1306492160",
    "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": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101218",
            "telephone_number": "812-450-4066",
            "fax_number": "812-429-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Clinic - DC at Work Berry Global",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.