DEACONESS CLINIC INC. NPI 1871749184

NPI Information

  • NPI: 1871749184
  • Provider Name: DEACONESS CLINIC INC.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 15D2049038
  • Address: 545 S BOEHNE CAMP RD
    EVANSVILLE, IN
    ZIP 47712
  • Phone: (812) 429-1818

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NPI Details

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 1871749184. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

545 S BOEHNE CAMP RD
EVANSVILLE, IN
ZIP 47712-703
Phone: (812) 429-1818
Fax: (812) 426-9564

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 15D2049038 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/18/2008 and was last updated on 10/27/2020.

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
1207K00000XAllergy & ImmunologyNo
2207R00000XInternal MedicineNo
3208000000XPediatricsNo
4363A00000XPhysician AssistantNo
5363L00000XNurse PractitionerNo
6207Q00000XFamily 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100051590OTHERKENTUCKYKY MEDICAID PHYSICIANS
27100051610OTHERKENTUCKYKY MEDICAID NP
37100051640OTHERKENTUCKYKY MEDICAID PODIATRY
4200910900MEDICAIDINDIANA

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: 11/21/2025

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