ST MARY'S MEDICAL GROUP LLC NPI 1154933703

NPI Information

  • NPI: 1154933703
  • Provider Name: ST MARY'S MEDICAL GROUP, LLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • CLIA Number: 15D0891285
  • Address: 3801 BELLEMEADE AVE STE 110
    EVANSVILLE, IN
    ZIP 47714
  • Phone: (812) 485-7330

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NPI Details

ST MARY'S MEDICAL GROUP, LLC is a foot and ankle surgery podiatrist in Evansville, IN. ST MARY'S MEDICAL GROUP, LLC NPI is 1154933703. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3801 BELLEMEADE AVE STE 110
EVANSVILLE, IN
ZIP 47714-111
Phone: (812) 485-7330

The provider's authorized official is Daniel Parod .
The authorized official title is Ceo and has the following contact phone number (812) 485-1502.

The CLIA number assigned to this NPI record is 15D0891285 - ambulatory surgery center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/17/2020 and was last updated on 8/17/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristNo
2213ES0131XPodiatristFoot SurgeryNo
3213ES0103XPodiatristFoot & Ankle SurgeryYes

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: 3/30/2025

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