St Marys Health Inc
Organization Active NPI Physiological Laboratory · Newburgh, IN
NPI 1730717331 · NPPES record last updated Jul 13, 2020
Key facts
- NPI
- 1730717331
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physiological Laboratory 293D00000X
- Legal business name
- ST MARYS HEALTH INC
- Practice address
- 100 St Marys Epworth Xing # C100
Newburgh, IN 47630-9497 - Phone
- (812) 469-8510
- NPI assigned
- Mar 30, 2020
- Organization subpart
- No
Authorized official
- Name
- Daniel Allen Parod
- Title
- Ceo
- Phone
- (812) 485-1509
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 23
Practitioners 57
-
Charles W Lackey, D.O.
-
Michael Alan Trevino, M.D.
-
Brandon Wynn, DO
-
Nosher Ali, MD
-
Joseph Amos, FNP
-
Maghan C Bretz, PT
-
Leslie Rae Pike Brown, M.D.
-
James Thomas Andrew Butler, MB MRCP
-
Vivian C Cook, M.D.
-
Sara Sue Coomes, PT
-
Caroline Coughlin, APRN
-
David B Curtis, M.D.
-
Jesse Doyle, MD
-
Haley Elpers, DPT
-
Dusky Rideout Farmer, D.P.M.
-
Devon Fetters, MD
-
Robert D Ficalora, M.D.
-
John T Gallagher, M.D.
-
Kylen Matthew Gray, PT, DPT
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0361268 | Ascension Medical Group St Vincent - Occupational | Certificate of waiver | Mar 19, 2027 |
| 15D2007161 | Ascension Medical Group St Vincent - Primary Care | Provider-performed microscopy | May 9, 2028 |
| 15D2007363 | Ascension Medical Group St Vincent - Primary Care | Certificate of waiver | May 22, 2028 |
| 15D2094165 | Ascension Medical Group St Vincent - Pediatrics | Certificate of waiver | Apr 12, 2027 |
| 15D2302993 | Ascension Medical Group St V - Epworth Crossing | Certificate of waiver | Apr 17, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200824001752 | IN | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 9133023898 | Practice locations: Newburgh, IN |
National Provider Directory
- Tax ID family
- St Marys Med Ctr
Locations
100 St Marys Epworth Xing
#A500
Newburgh, IN 47630
100 St Marys Epworth Xing
#C100
Newburgh, IN 47630
Phone (812) 469-8150
100 St Marys Epworth Xing
Ste C100
Newburgh, IN 47630
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | Yes |
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
- Ascension St. Vincent Evansville
Other providers in Newburgh, IN
- Sridhar Bhaskara MD LLC
- St Mary'S Breast Center, LLC
- St Mary'S Health Inc
- St Marys Health Inc
- St Marys Health Inc
- St Marys Health Inc
- St Marys Physicians Health Group LLC
- St. Mary'S at Home Inc
- St. Mary'S Breast Center, LLC
- St. Mary'S Health, Inc
All providers in Newburgh, IN · Physiological Laboratory in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.