NPIMap

Organization Active NPI

St Marys Health Inc

Doing business as Ascension St. Vincent Evansville

  • Physiological Laboratory
  • Newburgh, IN
National Provider Identifier
1730717331
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
ST MARYS HEALTH INC
Doing business as
Ascension St. Vincent Evansville
Practice address
100 St Marys Epworth Xing # C100
Newburgh, IN 47630-9497
Phone
(812) 469-8510
NPI assigned
Mar 30, 2020
Last updated
Jul 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Daniel Allen Parod
Title
Ceo
Phone
(812) 485-1509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

100 St Marys Epworth Xing # C100
Newburgh, IN 47630-9497

Mailing address

250 W 96TH St Ste 520
Indianapolis, IN 46260-1317

Other names 1

  • Ascension St. Vincent Evansville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200824001752 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9133023898 Practice locations: Newburgh, IN

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
15D0361268Ascension Medical Group St Vincent - Occupational100 St Mary's Epworth Crossing, Newburgh, IN 47630Certificate of waiverMar 19, 2027
15D2007161Ascension Medical Group St Vincent - Primary Care100 St Mary's Epworth Crossing, Ste A300, Newburgh, IN 47630Provider-performed microscopyMay 9, 2028
15D2007363Ascension Medical Group St Vincent - Primary Care100 St Mary's Epworth Crossing, Ste A200, Newburgh, IN 47630Certificate of waiverMay 22, 2028
15D2094165Ascension Medical Group St Vincent - Pediatrics100 St Mary's Epworth Crossing Ste A100, Newburgh, IN 47630Certificate of waiverApr 12, 2027
15D2302993Ascension Medical Group St V - Epworth Crossing100 St Mary's Epworth Crossing Suite B100, Newburgh, IN 47630Certificate of waiverApr 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Marys Medical Center Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

5927 Reliable Pkwy
Chicago, IL 60686

100 St Marys Epworth Xing
#A500
Newburgh, IN 47630

100 St Marys Epworth Xing
Ste C100
Newburgh, IN 47630

Practitioners & affiliated clinicians

Practitioners 7

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": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1730717331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST STE 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING # C100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497",
            "telephone_number": "812-469-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "PAROD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-485-1509"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent Evansville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ascension St. Vincent Evansville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.