Deaconess Clinic, Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DEACONESS CLINIC, INC

Practice address

4209 Gateway Blvd
Newburgh, IN 47630-8900

Phone

(812) 853-5300

Fax

(812) 858-4660

NPI assigned

Aug 12, 2008

Last updated

Nov 21, 2024By 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

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

Locations

Practitioners 86

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.

• Corie Ann Aiken, FNP

  • Nurse Practitioner
  • Evansville, IN
  • NPI 1326280868
  NPD
• Hazem Albandar, MD

  • Epilepsy Physician
  • Newburgh, IN
  • NPI 1134655491

  Neurology

  NPD
• Yousef Hamdi Altowaireb, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Evansville, IN
  • NPI 1104024363
  NPD
• Samuel Herbert Anderson-Been, MD

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1134798838
  NPD
• Mark D Ayers, M.D.

  • Pediatric Cardiology Physician
  • Indianapolis, IN
  • NPI 1093981342
  NPD
• William E. Bennett Jr., MD

  • Pediatric Gastroenterology Physician
  • Indianapolis, IN
  • NPI 1851566210
  NPD
• Madalyn Berendes, DO

  • Pediatrics Physician
  • Newburgh, IN
  • NPI 1366184087
  NPD
• Shawna Boyle, MD

  • Urology Physician
  • Fort Wayne, IN
  • NPI 1518347913
  NPD
• Antoinette Caldwell, M.D.

  • Pediatrics Physician
  • Evansville, IN
  • NPI 1871547042
  NPD
• Kayla D Cash, NP

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1437974029
  NPD
• Amanda Grace Chandler, FNP-C

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1134970452
  NPD
• John C Christenson, MD

  • Pediatric Infectious Diseases Physician
  • Indianapolis, IN
  • NPI 1548364052
  NPD

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1376799213",
    "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": "812-853-5300",
            "fax_number": "812-858-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308900",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "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": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "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": "2080P0208X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200910700F",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deaconess Clinic Inc. (Deaconess Clinic II)
• Deaconess Clinic, Inc (Deaconess Clinic I)
• Deaconess Clinic, Inc (Deaconess Clinic I)
• Deaconess Clinic, Inc
• Deaconess Clinic, Inc (Deaconess Clinic II)
• Deaconess Clinic, Inc (Deaconess Comp Center Gateway)
• Deaconess Clinic, Inc. (Deaconess Clinic - Wyntree)
• Deaconess Hospital Inc (Deaconess Pulmonary Critical Care - Gateway)
• Deaconess Hospital Inc (Deaconess Clinic Obstetrics and Gynecology Newburgh)
• Deaconess Hospital Inc

• Pediatrics Physician in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.