NPIMap

Organization Active NPI

Deaconess Union County Hospital, Inc

Doing business as Deaconess Union County Dixon

  • Family Medicine Physician
  • Dixon, KY
National Provider Identifier
1730762170
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DEACONESS UNION COUNTY HOSPITAL, INC
Doing business as
Deaconess Union County Dixon
Practice address
1355 US Highway 41a S
Dixon, KY 42409-9447
Phone
(270) 639-9101
Fax
(270) 639-9332
NPI assigned
May 4, 2021
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

1355 US Highway 41a S
Dixon, KY 42409-9447

Mailing address

PO Box 638705
Cincinnati, OH 45263-8705
Phone (270) 639-9101

Other names 1

  • Deaconess Union County Dixon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210811002781 KY Part B Supplier - Clinic/Group Practice 5799189866 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dixon, KY; Morganfield, KY

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Union Cty Hosp6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1730762170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638705",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638705",
            "telephone_number": "270-639-9101",
            "fax_number": "270-639-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 US HIGHWAY 41A S",
            "city": "DIXON",
            "state": "KY",
            "postal_code": "424099447",
            "telephone_number": "270-639-9101",
            "fax_number": "270-639-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS UNION COUNTY HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Union County Dixon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dixon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.