Deaconess Hospital, Inc
Organization Active NPI Family Medicine Physician · Evansville, IN
NPI 1336152156 · NPPES record last updated Sep 1, 2010
Key facts
- NPI
- 1336152156
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DEACONESS HOSPITAL, INC
- Practice address
- 8600 University Blvd
RM Hp0091
Evansville, IN 47712-3534 - Phone
- (812) 465-1250
- Fax
- (812) 465-7170
- NPI assigned
- Aug 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Linda E White
- Title
- President & Ceo
- Phone
- (812) 450-2250
Other NPIs on the same Medicare enrollment 43
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040115000129 | IN | Part B Supplier - Clinic/Group Practice | 9032021431 |
Receives reassigned benefits from 719 practitioners 43 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Evansville, IN; Newburgh, IN |
National Provider Directory
Locations
8600 University Blvd
Evansville, IN 47712
Phone (812) 465-1298
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
8600 University Blvd
RM Hp0091
Evansville, IN 47712-3534
Mailing address
PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-6815
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100272080K | Medicaid | IN | |
| CG1119 | Other | IN | RR MCARE GROUP # |
Other names
- USI Student Health Center
Other providers in Evansville, IN
- Deaconess Hospital Inc
- Deaconess Hospital Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
- Deaconess Hospital, Inc
All providers in Evansville, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.