NPIMap

Deaconess Clinic, Inc

Organization Active NPI Family Medicine Physician · Henderson, KY

NPI 1346869252 · NPPES record last updated Apr 10, 2020

Key facts

NPI
1346869252
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
DEACONESS CLINIC, INC
Practice address
411 Letcher St
Henderson, KY 42420-4245
Phone
(270) 831-7950
Fax
(270) 831-7824
NPI assigned
Apr 10, 2020
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

  • Mackenzie Denton, DO Family Medicine Physician · Hopkinsville, KY · NPI 1275159337
    NPD FAMILY MEDICINE
  • Carli Thomas Pediatrics Physician · Henderson, KY · NPI 1205287000
    NPD
  • Joseph H Wilson, DPM Foot & Ankle Surgery Podiatrist · Henderson, KY · NPI 1679198436
    NPD
  • Hope D Hoeing, NP Nurse Practitioner · Boonville, IN · NPI 1487406153
    NPD NURSE PRACTITIONER
  • Katie M Lawless, APRN Family Nurse Practitioner · Newburgh, IN · NPI 1770031098
    NPD NURSE PRACTITIONER

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2045413Deaconess Clinic Letcher
411 Letcher Street, Henderson, KY 42420		Certificate of waiverAug 11, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081017000259 KY Part B Supplier - Clinic/Group Practice 3375610116 Receives reassigned benefits from 190 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sebree, KY; Philpot, KY; Owensboro, KY; Morganfield, KY; Madisonville, KY; Henderson, KY; Dixon, KY

National Provider Directory

Tax ID family
Deaconess Clinc Inc (99 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

411 Letcher St
Henderson, KY 42420-4245

Mailing address

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

Other names

  • Deaconess Clinic - Letcher Doing business as

Other providers in Henderson, KY

All providers in Henderson, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.