NPIMap

Organization Active NPI

Deaconess Clinic Inc.

Doing business as Deaconess Clinic II

  • Hematology & Oncology Physician
  • Evansville, IN
National Provider Identifier
1669614103
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
DEACONESS CLINIC INC.
Doing business as
Deaconess Clinic II
Practice address
520 Mary Street
Suite 140
Evansville, IN 47710-1669
Phone
(812) 426-9411
Fax
(812) 426-9503
NPI assigned
Mar 30, 2009
Last updated
Aug 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Authorized official

Name
Cheryl A Wathen
Title
Cfo
Phone
(812) 450-3296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

520 Mary Street
Suite 140
Evansville, IN 47710-1669

Mailing address

PO Box 3868
Evansville, IN 47737-3868
Phone (812) 426-9411

Other names 1

  • Deaconess Clinic II Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080922000145 IN Part B Supplier - Clinic/Group Practice 3375610116 Receives reassigned benefits from 477 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Clinic Inc100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

520 Mary St
Ste 140
Evansville, IN 47710
Phone (812) 424-1200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502323200000",
    "number": "1669614103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477373868",
            "telephone_number": "812-426-9411",
            "fax_number": "812-426-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY STREET",
            "address_2": "SUITE 140",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101669",
            "telephone_number": "812-426-9411",
            "fax_number": "812-426-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2017-08-10",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Clinic II",
            "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 Aug 10, 2017; 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.