Vanderburgh County

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D0361375 Issued in IN

Legal business name

VANDERBURGH COUNTY

Practice address

420 Mulberry St
Oak Park Professional Building
Evansville, IN 47713-1231

Phone

(812) 435-5568

Fax

(812) 435-5468

NPI assigned

Oct 20, 2006

Reactivated

Sep 30, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Robert Kenneth Spear Jr., M.D.

Title

Health Officer

Phone

(812) 435-5684

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vanderburgh Co. Dept. of Health Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1801979331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MULBERRY ST",
            "address_2": "OAK PARK PROFESSIONAL BUILDING",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131231",
            "telephone_number": "812-435-5443",
            "fax_number": "812-435-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MULBERRY ST",
            "address_2": "OAK PARK PROFESSIONAL BUILDING",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131231",
            "telephone_number": "812-435-5568",
            "fax_number": "812-435-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDERBURGH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "deactivation_date": "2019-05-31",
        "reactivation_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "SPEAR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "812-435-5684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D0361375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100284730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanderburgh Co. Dept. of Health Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlie R Van Voorst, NP
• Deetta Kay Vance, DNP, APRN, FNP-BC
• Russell Edward Vance III, PHD
• Diane Sue Vancleave, PH.D, MSSW
• Vanderburgh County
• Sarah Vanderhoof-Dossett
• Cynthia Lyn Vanhooser, PTA
• Angela Renee Vanmatre, FNP
• Samuel Vanover
• Mallory Nichole Vanwynsberghe, PHARMD

• Clinical Medical Laboratory in Evansville, IN
• Providers in Evansville, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.