DEACONESS CLINIC INC. (NPI# 1033365986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033365986 |
| Entity Type | Organization |
| Organization Name | DEACONESS CLINIC INC. |
| Other Organization Name | DEACONESS CLINIC II |
| Practice Address |
4233 Gateway Blvd Newburgh IN 47630-8900 |
| Mailing Address |
Po Box 1510 Evansville IN 47706-1510 |
| Practice Telephone | 8124266638 |
| Practice Fax Number | 8124508109 |
| Mailing Telephone | 8124266638 |
| Mailing Fax Number | 8124508109 |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2020-09-23 |
| Authorized Official Name | CHERYL A WATHEN (CFO) |
| Authorized Official Telephone | 8124503296 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | KY MEDICAID PODIATRY | 7100051640 | 01 |
| KY | KENTUCKY MEDICAID PHYSICIAN ASSISTANCE | 7100318210 | 01 |
| IN | 200910900 | 05 | |
| KY | KY MEDICAID NURSE PRACTITIONER | 7100302340 | 01 |
| KY | KY MEDICAID PHYSICIANS | 7100302450 | 01 |
| Other Name | Type Code |
|---|---|
| Deaconess Clinic II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669614103 | Deaconess Clinic Inc. | Internal Medicine | 520 Mary Street, Suite 140, Evansville, IN 47710-1669 | 2009-03-30 |
| 1871749184 | Deaconess Clinic Inc. | Allergy & Immunology | 545 S Boehne Camp Rd, Evansville, IN 47712-3703 | 2008-08-18 |
| 1023264306 | Deaconess Clinic Inc. | Internal Medicine | 8600 N Kentucky Ave, Evansville, IN 47725-6302 | 2008-08-18 |
| 1659527935 | Deaconess Clinic Inc. | Podiatrist | 685 Vail Street, Princeton, IN 47670-9510 | 2008-08-18 |
| 1619123585 | Deaconess Clinic Inc. | Internal Medicine | 421 Chestnut St, Evansville, IN 47713 | 2008-08-12 |
| 1699921585 | Deaconess Clinic Inc. | Family Medicine | 3434 W State Road 66, Rockport, IN 47635-9259 | 2008-08-12 |
| Street Address |
4233 GATEWAY BLVD |
| City | NEWBURGH |
| State | IN |
| Zip Code | 47630-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982673661 | Ayaz Shaikh | Plastic Surgery | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2006-03-16 |
| 1346899465 | Rachel D Roy | Nurse Practitioner | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2019-09-11 |
| 1407335318 | Jessica L Conner | Nurse Practitioner | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2018-08-10 |
| 1619454188 | Erica R Thomason | Nurse Practitioner | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2018-07-26 |
| 1255875092 | Katherine L Waits | Nurse Practitioner | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2016-12-13 |
| 1689058356 | Lorin Mickelsen Iv | Podiatrist | 4233 Gateway Blvd, Newburgh, IN 47630 | 2015-07-13 |
| 1629462635 | Tyler Tidwell | Podiatrist | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2015-03-27 |
| 1588083778 | Sally Elizabeth Vanwinkle | Physician Assistant | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2014-04-15 |
| 1003233263 | Gordon Brown | Family Medicine | 4233 Gateway Blvd, Newburgh, IN 47630-8900 | 2014-03-26 |
| 1649534496 | Tanaporn Rasameesoraj | Psychiatry & Neurology | 4233 Gateway Blvd, Newburgh, IN 47630 | 2012-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477199859 | Dana Marie Deken | Physical Therapy Assistant | 322 Bell Oaks, Newburgh, IN 47630 | 2019-11-21 |
| 1851948897 | Riley Elizabeth Eilken | Physical Therapist | 4233 Gateway Glbd, Suite 201, Newburgh, IN 47630 | 2019-08-23 |
| 1851851174 | Jennifer Ozete Cole | Physical Therapist | 4233 Gateway Boulvard Suite 201, Newburgh, IN 47630 | 2019-03-22 |
| 1174014542 | Katherine E Lyle | Music Therapist | 1003 Sr 662 W, Newburgh, IN 47630 | 2018-05-22 |
| 1144719923 | Jennifer Michelle Huffman | Occupational Therapy Assistant | 9800 Lincolne Avenue, Newburgh, IN 47630 | 2018-05-07 |
| 1215431846 | Deaconess Specialty Physicians, Inc | Internal Medicine | 4007 Gateway Blvd Ste 100, Newburgh, IN 47630 | 2018-03-20 |
| 1801313002 | Deaconess Hospital, Inc | Pharmacy | 4209 Gateway Blvd., Newburgh, IN 47630 | 2017-08-28 |
| 1629435599 | Caitlyn Beckinger | Physical Therapy Assistant | 9800 Lincoln Ave, Newburgh, IN 47630 | 2016-01-24 |
| 1568869410 | Jill Buck | Social Worker | 8788 Ruffian Ln Ste D, Newburgh, IN 47630 | 2014-11-20 |
| 1003191057 | Marshall Alan Cox | Pharmacist | 7769 Hwy 66, Newburgh, IN 47630 | 2011-10-20 |
| Find all providers in zip 47630 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093874620 | Annie Samina Aziz | Family Medicine | 200 Lake Street, Newburgh, NY 12550-5243 | 2006-12-08 |
| 1336212331 | Clovis E Manley | Family Medicine | 4943 Rosebud Ln, Newburgh, IN 47630-9226 | 2006-11-16 |
| 1417050089 | James Darrigo | Family Medicine | 38 North Plank Rd, Newburgh, NY 12550 | 2006-09-07 |
| 1831101757 | Anjali N Shah | Family Medicine | 310 Fullerton Ave, Suite 101, Newburgh, NY 12550-3724 | 2006-08-12 |
| 1407804602 | Deaconess Clinic, Inc | Family Medicine | 10455 Orthopaedic Dr, Newburgh, IN 47630-7955 | 2006-05-04 |
| 1558332734 | Melinda Brown Jackson | Family Medicine | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2006-01-27 |
| 1114904380 | Carleen M Rubel | Family Medicine | 3799 Venetian Way, Newburgh, IN 47630-8278 | 2005-12-28 |
| 1396722757 | Harry C Harvey | Family Medicine | 8077 Rose Hill Dr, Newburgh, IN 47630-2811 | 2005-12-28 |
| 1073598330 | Jon Scott Uloth | Family Medicine | 3711 Casey Rd, Newburgh, IN 47630-8343 | 2005-12-09 |
| 1841273968 | Krishna R. Chilukuri | Family Medicine | 4166 Wyntree Dr, Suite A, Newburgh, IN 47630-2521 | 2005-11-22 |
| Find all providers in NEWBURGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.