NPIMap

Organization Active NPI

St Mary'S Medical Group, LLC

  • Occupational Medicine Clinic/Center
  • Evansville, IN
National Provider Identifier
1669939617
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
ST MARY'S MEDICAL GROUP, LLC
Practice address
14020 Old State Rd
Evansville, IN 47725-1121
Phone
(812) 485-6900
NPI assigned
Feb 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Brian Morris
Title
Cfo (SVMG)
Phone
(317) 338-6234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

14020 Old State Rd
Evansville, IN 47725-1121

Mailing address

14020 Old State Rd
Evansville, IN 47725-1121

Other names 1

  • St. Vincent Evansville Occupational Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Marys Physicians Health Group LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

801 Saint Marys Dr
Ste 406E
Evansville, IN 47714
Phone (812) 479-1511

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1669939617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14020 OLD STATE RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477251121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14020 OLD STATE RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477251121",
            "telephone_number": "812-485-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO (SVMG)",
        "authorized_official_telephone_number": "317-338-6234"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Vincent Evansville Occupational Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Vincent Evansville Occupational Medicine",
            "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 May 13, 2021; 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.