Provider Type Icon

DEACONESS CLINIC INC NPI 1093000283


NPI Information

NPI: 1093000283
Provider Name: DEACONESS CLINIC INC

Doing Business As: DEACONESS CLINIC I

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D0965649

Address:
8600 UNIVERSITY BLVD
ROOM HP0091
EVANSVILLE, IN
ZIP 47712
Phone: (812) 465-1250
Get Directions

DEACONESS CLINIC INC is a family medicine in Evansville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DEACONESS CLINIC INC NPI is 1093000283. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Clinic I.

The provider's business location address is:

8600 UNIVERSITY BLVD
ROOM HP0091
EVANSVILLE, IN
ZIP 47712-534
Phone: (812) 465-1250
Fax: (812) 465-7170

The provider's authorized official is Cheryl A Wathen .
The authorized official title is Cfo and has the following contact phone number (812) 450-3296.

The CLIA number assigned to this NPI record is 15D0965649 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/15/2011 and was last updated on 8/10/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerNo
2207R00000XInternal MedicineNo
31041C0700XSocial WorkerClinicalNo
4207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1257900MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.