Organization Active NPI

Ascension Medical Group

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1669226593
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASCENSION MEDICAL GROUP
Practice address
3838 N 1St Ave
Evansville, IN 47710-3326
Phone
(812) 485-8119
NPI assigned
Apr 16, 2024
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Danielle Douglas
Title
Billing Coordinator
Phone
(812) 485-8119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3838 N 1St Ave
Evansville, IN 47710-3326

Mailing address

3838 N 1St Ave
Evansville, IN 47710-3326

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0911967Ascension Medical Group St Vincent - Pediatrics3838 N First Street Suite C, Evansville, IN 47710Certificate of waiverFeb 19, 2028
15D0970475Ascension Medical Group St Vincent - Primary Care3838 N First Ave Ste E, Evansville, IN 47710Provider-performed microscopyDec 10, 2026
15D1068357Ascension Medical Group St Vincent - Primary Care3838 N First Avenue Suite D, Evansville, IN 47710Certificate of waiverMay 8, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1669226593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103326",
            "telephone_number": "812-485-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "812-485-8119"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.