Evansville Mental Health and Wellness Center Co

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EVANSVILLE MENTAL HEALTH AND WELLNESS CENTER CO

Practice address

4972 Lincoln Ave Ste 101
Evansville, IN 47715-7909

Phone

(812) 402-3700

Fax

(812) 402-4611

NPI assigned

Nov 1, 2024

Organization subpart

No

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

Authorized official

Name

Kelly Osborne-Byrd

Title

Vice Presedent

Phone

(812) 901-0825

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1346063138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 LINCOLN AVE STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157909",
            "telephone_number": "812-402-3700",
            "fax_number": "812-402-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 LINCOLN AVE STE 101",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157909",
            "telephone_number": "812-402-3700",
            "fax_number": "812-402-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSVILLE MENTAL HEALTH AND WELLNESS CENTER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "OSBORNE-BYRD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "VICE PRESEDENT",
        "authorized_official_telephone_number": "812-901-0825"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evansville Pelvic Wellness & Rehabilitation LLC
• Evansville Plastic Surgical Associates

• Internal Medicine Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.