DEACONESS SPECIALTY PHYSICIANS, INC (NPI# 1124522750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124522750 |
Entity Type | Organization |
Organization Name | DEACONESS SPECIALTY PHYSICIANS, INC |
Practice Address |
1300 Merritt Dr Ste 110 Henderson KY 42420-2788 |
Mailing Address |
Po Box 1230 Evansville IN 47706-1230 |
Practice Telephone | 2708278811 |
Practice Fax Number | 2708278855 |
Mailing Telephone | 8124507899 |
Mailing Fax Number | 8124506029 |
Enumeration Date | 2018-03-20 |
Last Update Date | 2019-08-30 |
Authorized Official Name | CHERYL A WATHEN (SECRETARY/TREASURER) |
Authorized Official Telephone | 8124503296 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508363185 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1340 Il Highway 1 Ste A, Carmi, IL 62821 | 2018-04-10 |
1396249926 | Deaconess Specialty Physicians, Inc | Physician Assistant | 1813 Willow St Ste 5a, Vincennes, IN 47591-4279 | 2018-03-20 |
1215431846 | Deaconess Specialty Physicians, Inc | Internal Medicine | 4007 Gateway Blvd Ste 100, Newburgh, IN 47630 | 2018-03-20 |
1841763380 | Deaconess Specialty Physicians, Inc | Internal Medicine | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-01-08 |
1477041556 | Deaconess Specialty Physicians, Inc | Internal Medicine | 4015 Gateway Blvd Ste 2120, Newburgh, IN 47630 | 2018-04-25 |
1831693217 | Deaconess Specialty Physicians, Inc | Internal Medicine | 800 E Locust St, Olney, IL 62450 | 2018-03-21 |
1174027544 | Deaconess Specialty Physicians, Inc | Internal Medicine | 209 Nw 11th St, Fairfield, IL 62837 | 2018-03-21 |
1760986392 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1418 College Dr, Mount Carmel, IL 62863 | 2018-03-20 |
1851895486 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1808 Sherman Dr, Princeton, IN 47670 | 2018-03-20 |
1114421740 | Deaconess Specialty Physicians, Inc | Internal Medicine | 2200 E Parrish Ave Bldg A, Owensboro, KY 42303 | 2018-03-20 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | DEACONESS SPECIALTY PHYSICIANS, INC. | 600 Mary St, Evansville, IN 47710-1658 |
Street Address |
1300 MERRITT DR STE 110 |
City | HENDERSON |
State | KY |
Zip Code | 42420-2788 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710329776 | Jovil Kannampuzha | Internal Medicine | 1300 Merritt Dr Ste 110, Henderson, KY 42420-2788 | 2013-07-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
Find all providers in zip 42420 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164909396 | Nevada Heart and Vascular Center, (resh) LLP. | Internal Medicine | 2839 St. Rose Pkwy., Ste. 160, Henderson, NV 89052-4849 | 2018-07-20 |
1255823571 | Ram K Singh Md Ltd | Internal Medicine | 10410 S Eastern Ave Ste 210, Henderson, NV 89052-4195 | 2018-06-01 |
1710329776 | Jovil Kannampuzha | Internal Medicine | 1300 Merritt Dr Ste 110, Henderson, KY 42420-2788 | 2013-07-19 |
1285837997 | Alfonso Li Tiu | Internal Medicine | 3032 Palatine Terrace Dr, Henderson, NV 89052-3000 | 2007-06-08 |
1518056464 | Anjum Ismail | Internal Medicine | 2641 W Horizon Ridge Pkwy, Suite 120, Henderson, NV 89052-4830 | 2006-10-11 |
1053411165 | Sydney Glen Short | Internal Medicine | 568 Ruin Creek Rd Ste 128, Henderson, NC 27536-5921 | 2006-09-25 |
1366540973 | Sanjay Vohra | Internal Medicine | 8965 S Pecos Rd, Suite 12a, Henderson, NV 89074 | 2006-09-20 |
1205864865 | Joshua G Leichman | Internal Medicine | 2865 Siena Heights Dr Ste 331, Henderson, NV 89052-4171 | 2006-06-30 |
1205882339 | Chandrasekhar R. Narala | Internal Medicine | 2847 St Rose Pkwy, Ste 100, Henderson, NV 89052 | 2006-05-26 |
1699726240 | Sunil Kalla | Internal Medicine | 2779 W Horizon Ridge Pkwy, Suite #240, Henderson, NV 89052-4184 | 2006-05-16 |
Find all providers in HENDERSON |
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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.