Individual provider Active NPI

Alison Canaan

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1508591959
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71012562A Issued in IN
Practice address
309 N First Ave
Evansville, IN 47710-1218
Phone
(812) 450-4066
NPI assigned
Jul 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71012562A IN Primary

Addresses

Primary practice location

309 N First Ave
Evansville, IN 47710-1218

Mailing address

309 N First Ave
Evansville, IN 47710-1218
Phone (812) 450-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027000361 IN Order and Referring Only - Nurse Practitioner 7012383409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71012562AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc. CurrentSince Jul 24, 2022 Accepting new patients

Locations

309 N 1st Ave
Evansville, IN 47710
Phone (812) 450-4066

Interoperability endpoints

  • Direct secure messaging: acanaan11750@direct.deaconess.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1508591959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 N FIRST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101218",
            "telephone_number": "812-450-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N FIRST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101218",
            "telephone_number": "812-450-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAAN",
        "first_name": "ALISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012562A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.