Deaconess Memorial Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEACONESS MEMORIAL MEDICAL CENTER INC

Doing business as

Crawford County Family Medicine

Practice address

6402 E Industrial Lane
Leavenworth, IN 47137-8316

Phone

(877) 291-6488

NPI assigned

Mar 5, 2012

Last updated

Aug 27, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

DEACONESS MEMORIAL MEDICAL CENTER INCAs reported in NPPES

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

Authorized official

Name

Keith Miller

Title

Cao & Indiana Region President

Phone

(812) 996-0507

Specialties & licenses 1

Addresses

Other names 1

• Crawford County Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Deaconess Memorial Medical Center Inc

  dba Memorial Health Bristow

  • Family Medicine Physician
  • Bristow, IN
  • NPI 1134503279

  O20081211000204

  Same enrollment
• Deaconess Memorial Medical Center Inc

  dba French Lick Family Medicine

  • Rural Health Clinic/Center
  • French Lick, IN
  • NPI 1881843522

  O20081211000204

  Same enrollment

Part of

Little Company Hosp in Inc

Locations

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1972877280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1028",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475471028",
            "telephone_number": "812-996-8476",
            "fax_number": "812-996-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 E INDUSTRIAL LANE",
            "city": "LEAVENWORTH",
            "state": "IN",
            "postal_code": "471378316",
            "telephone_number": "877-291-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS MEMORIAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEACONESS MEMORIAL MEDICAL CENTER INC",
        "enumeration_date": "2012-03-05",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CAO & INDIANA REGION PRESIDENT",
        "authorized_official_telephone_number": "812-996-0507"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford County Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alana K Bartlett, PT
• Black Pine Real Estate, LLC
• Extendicare Health Services
• Jill Fleace, COTA
• Harrison County Hospital (Harrison Crawford Healthcare)
• Julie Hillenbrand Sellner, COTA
• Indiana Health and Rehabilitation Centers (Todd-Dickey Nursing & Rehabilitation Center)

• Family Medicine Physician in Leavenworth, IN
• Providers in Leavenworth, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.