Physician Management Services of Western Indiana, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01050928A Issued in IN

Legal business name

PHYSICIAN MANAGEMENT SERVICES OF WESTERN INDIANA, LLC

Practice address

4933 E Plaza East Blvd
Evansville, IN 47715-2813

Phone

(888) 829-8550

NPI assigned

Jul 11, 2016

Last updated

Jul 24, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

VAXCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Casey Deloach

Title

Manager

Phone

(888) 829-8550

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Vaxcare LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vaxcare LLC

  dba VaxCare

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1316058217

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1497107775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAGNOLIA AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033264",
            "telephone_number": "888-829-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 E PLAZA EAST BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152813",
            "telephone_number": "888-829-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Hunter Station Way Ste 202",
            "address_purpose": "LOCATION",
            "city": "Sellersburg",
            "state": "IN",
            "postal_code": "471728932",
            "country_code": "US",
            "telephone_number": "888-829-8550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 S Saint Louis Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466173044",
            "country_code": "US",
            "telephone_number": "888-829-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN MANAGEMENT SERVICES OF WESTERN INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2016-07-11",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "DELOACH",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01050928A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PHC059",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.