Individual provider Active NPI

Vicki L McNeill, NP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1508957457
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001505A Issued in IN
Practice address
600 Mary St
Evansville, IN 47747-0001
Phone
(812) 450-3405
Fax
(812) 450-3099
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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 71001505A IN Primary

Addresses

Primary practice location

600 Mary St
Evansville, IN 47747-0001

Mailing address

PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-3405

Other identifiers 4

IdentifierTypeStateIssuer
78009230MedicaidKY
000000308438OtherINBCBS - MARY STREET
000000381101OtherINBCBS - GATEWAY
200418070MedicaidIN

Other names 1

  • Vicki L Wagner Former name

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
I20081208000043 IN Practitioner - Nurse Practitioner 5092876235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001505AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital Inc Nurse Practitioner CurrentSince Feb 3, 2003 Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner Current Accepting new patients
Deaconess Hospital, Inc Nurse Practitioner CurrentSince Feb 3, 2003 Accepting new patients

Locations

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1508957457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3405",
            "fax_number": "812-450-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-3405",
            "fax_number": "812-450-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEILL",
        "first_name": "VICKI",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001505A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78009230",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MARY STREET",
            "identifier": "000000308438",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - GATEWAY",
            "identifier": "000000381101",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200418070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "WAGNER",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.