Deaconess Specialty Physicians, Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

DEACONESS SPECIALTY PHYSICIANS, INC

Practice address

1200 N East St
Olney, IL 62450-2432

Phone

(812) 464-9133

Fax

(812) 450-6029

NPI assigned

Mar 21, 2018

Last updated

Jun 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheryl A Wathen

Title

Secretary/Treasurer

Phone

(812) 450-3296

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 9

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

• Deaconess Specialty Physicians

  • Clinical Cardiac Electrophysiology Physician
  • Eldorado, IL
  • NPI 1871366567

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Fairfield, IL
  • NPI 1003317785

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Fairfield, IL
  • NPI 1174027544

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Interventional Cardiology Physician
  • Carmi, IL
  • NPI 1174295224

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • McLeansboro, IL
  • NPI 1437650116

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Carmi, IL
  • NPI 1508363185

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Mount Carmel, IL
  • NPI 1760986392

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Olney, IL
  • NPI 1972004653

  O20180523001150

  Same enrollment
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Evansville, IN
  • NPI 1306344817

  O20180523001150

  Same enrollment

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1831693217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061230",
            "telephone_number": "812-450-7899",
            "fax_number": "812-450-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N EAST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502432",
            "telephone_number": "812-464-9133",
            "fax_number": "812-450-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS SPECIALTY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Shawn Curtis, CRNA
• Heather Nichole Curtis, NP-C
• Pamela M Curtis, AUD
• Destiny R Dannells, NP-C
• Charlotte Davies
• Deaconess Specialty Physicians, Inc
• Niranat Dejtiranukul, M.D.
• Clark Edward Deshon, O.D., F.A.A.O
• Danielle Renee Deters, PHARMD
• Developmental Specialists of Southeastern Il, Inc.

• Cardiovascular Disease Physician in Olney, IL
• Providers in Olney, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.