NPIMap

Organization Active NPI

Deaconess Hospital, Inc.

Doing business as Deaconess Home Medical

  • Home Infusion Agency
  • Evansville, IN
National Provider Identifier
1659441483
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
69000101A Issued in IN
Legal business name
DEACONESS HOSPITAL, INC.
Doing business as
Deaconess Home Medical
Practice address
701 Garfield Ave
Evansville, IN 47710-1771
Phone
(812) 450-4673
Fax
(812) 450-4665
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Stephen E. Camp
Title
Manager
Phone
(812) 450-6148

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X 69000101A IN Primary
Oxygen Equipment & Supplies (DME) 332BX2000X 69000101A IN
Home Infusion Therapy Pharmacy 3336H0001X 60001691A IN

Addresses

Primary practice location

701 Garfield Ave
Evansville, IN 47710-1771

Mailing address

600 Mary St
Evansville, IN 47747-0001
Phone (812) 450-4673

Other identifiers 3

IdentifierTypeStateIssuer
200424320AMedicaidIN
90234451MedicaidKY
35059390401MedicaidIL

Other names 1

  • Deaconess Home Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tom P Martin MD46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1659441483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-4673",
            "fax_number": "812-450-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GARFIELD AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101771",
            "telephone_number": "812-450-4673",
            "fax_number": "812-450-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "812-450-6148"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "IN",
            "license": "69000101A",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IN",
            "license": "69000101A",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "IN",
            "license": "60001691A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200424320A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90234451",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35059390401",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.