NPIMap

Organization Active NPI

Deaconess Vna Plus, LLC

  • Community Based Hospice Care Agency
  • Evansville, IN
National Provider Identifier
1821173790
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
15-005939-1 Issued in IN
Legal business name
DEACONESS VNA PLUS, LLC
Practice address
611 Harriet St
Evansville, IN 47710-1773
Phone
(812) 450-7022
NPI assigned
Oct 26, 2006
Last updated
May 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Mrs. Leigh Ann Gamble
Title
Director
Phone
(812) 450-3980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 15-005939-1 IN Primary

Addresses

Primary practice location

611 Harriet St
Evansville, IN 47710-1773

Mailing address

611 Harriet St
Evansville, IN 47710-1773
Phone (812) 450-7021

Other identifiers 6

IdentifierTypeStateIssuer
200141390BOtherINMEDICAID- PRINCETON
200141390AMedicaidIN
200141390COtherMEDICAID- TELL CITY
184508OtherINBLUE CROSS PRINCETON
183988OtherINBLUE CROSS EVANSVILLE
257417OtherINBLUE CROSS TELL CITY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140821001934 IN Part A Provider - Hospice 4486871035 Practice locations: Evansville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821173790. Details of each certification follow.

Hospice certification: CCN 151518

Legal name
DEACONESS VNA PLUS LLC
Doing business as
DEACONESS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 28, 1992
Last certification
May 12, 2022
Ownership / control type
Non-Profit - Other
Organization structure
LLCNon-profit
Incorporated
Mar 25, 2014 in IN
Enrollment address
611 Harriet St
Evansville, IN 47710-1773

Care Compare: Hospice

Medicare Care Compare
Listed as
Deaconess HospiceCCN 151518 · All quality measures
Ownership
Other
Certified
Aug 28, 1992
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patricia Killion Individual Operational/Managerial ControlBoard Member Jul 31, 2024
Marc J Florence Individual Operational/Managerial ControlBoard Member Oct 18, 2022
Allison Flowers Individual Corporate Officer Oct 1, 2024
Operational/Managerial Control Oct 1, 2024
Deaconess Health System Inc Organization, Evansville, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2016 100%
Crystal Heaton Individual Corporate OfficerDirector of Finance Aug 19, 2016 100%
W-2 Managing EmployeeDirector of Finance Aug 19, 2016 100%
Operational/Managerial ControlDirector of Finance Aug 19, 2016 100%
Traci Robinson Individual Operational/Managerial ControlBoard Member Oct 18, 2022
Danielle Naas Individual Corporate Director Mar 9, 2022
W-2 Managing Employee Mar 9, 2022
April Michelle-Simmons Toelle Individual Operational/Managerial ControlBoard Secretary Oct 18, 2022
James Porter Individual Operational/Managerial ControlBoard Member Oct 18, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 28

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 28

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1821173790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HARRIET ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101773",
            "telephone_number": "812-450-7021",
            "fax_number": "812-450-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 HARRIET ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101773",
            "telephone_number": "812-450-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS VNA PLUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "LEIGH ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-450-3980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IN",
            "license": "15-005939-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- PRINCETON",
            "identifier": "200141390B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200141390A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- TELL CITY",
            "identifier": "200141390C",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PRINCETON",
            "identifier": "184508",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS EVANSVILLE",
            "identifier": "183988",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS TELL CITY",
            "identifier": "257417",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.