NPIMap

Organization Active NPI

Deaconess Specialty Physicians Inc

  • Physical Therapist
  • Jasper, IN
National Provider Identifier
1902799893
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DEACONESS SPECIALTY PHYSICIANS INC
Practice address
1900 Saint Charles St
Jasper, IN 47546-9145
Phone
(812) 490-4550
Fax
(812) 858-8664
NPI assigned
May 30, 2025
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Cheryl Annette Wathen
Title
Cfo
Phone
(812) 450-3296

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

1900 Saint Charles St
Jasper, IN 47546-9145

Mailing address

PO Box 632111
Cincinnati, OH 45263-2111
Phone (812) 450-6879

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180702001637 IN Part B Supplier - Clinic/Group Practice 0244595205 Receives reassigned benefits from 283 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newburgh, IN; Washington, IN; Vincennes, IN; Santa Claus, IN; Princeton, IN; Linton, IN; Jasper, IN; Evansville, IN…

Other NPIs on the same Medicare enrollment 30

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

View all 30

National Provider Directory

National Provider Directory
Tax ID family
Deaconess Specialty Physicians Inc43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 5

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": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1902799893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632111",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632111",
            "telephone_number": "812-450-6879",
            "fax_number": "812-450-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-490-4550",
            "fax_number": "812-858-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS SPECIALTY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-450-3296"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.