NPIMap

Organization Active NPI

Deaconess Speciality Physicians, Inc

  • Orthopaedic Surgery Physician
  • Evansville, IN
National Provider Identifier
1720710544
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DEACONESS SPECIALITY PHYSICIANS, INC
Practice address
515 Read St
Evansville, IN 47710-1739
Phone
(812) 450-6966
NPI assigned
Jun 29, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Hand Surgery Physician 207XS0106X NU
Orthopaedic Trauma Physician 207XX0801X NU

Addresses

Primary practice location

515 Read St
Evansville, IN 47710-1739

Mailing address

PO Box 1230
Evansville, IN 47706-1230
Phone (812) 450-6815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180702001637 IN Part B Supplier - Clinic/Group Practice 0244595205 Receives reassigned benefits from 283 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newburgh, IN; Washington, IN; Vincennes, IN; Santa Claus, IN; Princeton, IN; Linton, IN; Jasper, IN; Evansville, IN…

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Specialty Physicians Inc43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 4

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": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1720710544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061230",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-450-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS SPECIALITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 29, 2022; 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.