DEACONESS SPECIALTY PHYSICIANS, INC (NPI# 1174027544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174027544 |
| Entity Type | Organization |
| Organization Name | DEACONESS SPECIALTY PHYSICIANS, INC |
| Practice Address |
209 Nw 11th St Fairfield IL 62837 |
| Mailing Address |
Po Box 1230 Evansville IN 47706-1230 |
| Practice Telephone | 8124507899 |
| Practice Fax Number | 8124506029 |
| Mailing Telephone | 8124507899 |
| Mailing Fax Number | 8124506029 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-05-15 |
| 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 | ||
| 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 |
| 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 |
| 1124522750 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1300 Merritt Dr Ste 110, Henderson, KY 42420-2788 | 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 |
209 NW 11TH ST |
| City | FAIRFIELD |
| State | IL |
| Zip Code | 62837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539918 | David K Israel | Pediatrics | 209 Nw 11th St, # 209, Fairfield, IL 62837-1218 | 2005-06-27 |
| 1245873579 | Ashten Taylor | Licensed Practical Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2019-10-18 |
| 1528622644 | Allison Frost | Nurse Practitioner | 209 Nw 11th St, Fairfield, IL 62837 | 2019-04-24 |
| 1467016758 | Christina M Copeland | Licensed Practical Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2019-04-23 |
| 1184190829 | Matthew Dean Brown | Physician Assistant | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2018-10-20 |
| 1518413988 | Natalie Maas | Registered Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2016-08-26 |
| 1891248423 | Christina Schuck | Registered Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2016-08-01 |
| 1750765004 | Rebecca Anthony | Registered Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2015-07-16 |
| 1174919724 | Taylor Loudermilk | Registered Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2015-04-10 |
| 1336531409 | Mckenna Loss | Registered Nurse | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2015-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294619 | Katelyn Atteberry | Pharmacist | 150 Commerce Drive, Fairfield, IL 62837 | 2020-10-30 |
| 1265894521 | Rebecca August | Social Worker | 506 Nw 9th St, Fairfield, IL 62837 | 2016-03-25 |
| 1063814259 | Kathie L Hill | Social Worker | 303 Nw 11th St., Fairfield Memorial Hospital, Fairfield, IL 62837 | 2014-09-19 |
| 1912206731 | Way-fair Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 305 Northwest 11th Street, Fairfield, IL 62837 | 2011-03-18 |
| 1063600773 | Alvin Ewing | Counselor | 407 N. Basin Road, Fairfield, IL 62837 | 2007-10-09 |
| 1417145129 | Gilbert Tennyson | Counselor | 407 North Basin Rd, Fairfield, IL 62837 | 2007-10-09 |
| 1972791689 | Clint Harvey | Counselor | 407 North Basin Road, Fairfield, IL 62837 | 2007-10-09 |
| 1770789778 | Fairfield Estates, LLC | Point of Service | 315 North Market Street, Fairfield, IL 62837 | 2007-06-26 |
| 1346382207 | Robert E Lowry | Counselor | 407 N Basin Rd., Fairfield, IL 62837 | 2007-02-13 |
| 1790840825 | Bradley D Kramer | Dentist | 301 Nw 11th Street, Suite 212, Fairfield, IL 62837 | 2006-12-27 |
| Find all providers in zip 62837 | ||||
| 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 |
|---|---|---|---|---|
| 1346249018 | David G Babbitt | Internal Medicine | 3000 Mack Rd # 100, Fairfield, OH 45014-5335 | 2005-07-15 |
| 1972500676 | Milind Dhond | Internal Medicine | 1860 Pennsylvania Ave, Suite 120, Fairfield, CA 94533-3590 | 2005-07-07 |
| 1225370901 | Eric Louis Alter | Internal Medicine | 425 Post Rd, Fairfield, CT 06824-6232 | 2013-03-20 |
| 1366745267 | Northeast Medical Group, Inc | Internal Medicine | 1305 Post Rd, Suite 105, Fairfield, CT 06824-6016 | 2010-12-15 |
| 1871811430 | Awan Professional Medical Corp. | Internal Medicine | 1525 Webster St, Suite A, Fairfield, CA 94533-4997 | 2010-05-06 |
| 1427374305 | Ari T Pollack | Internal Medicine | 1305 Post Rd, Lower Level, Fairfield, CT 06824-6016 | 2010-04-16 |
| 1851626394 | Jeffrey Breneisen Md Inc. | Internal Medicine | 1261 Travis Blvd, Suite 200, Fairfield, CA 94533-4897 | 2009-10-15 |
| 1447585161 | Milind Dhond Md Inc | Internal Medicine | 1261 Travis Blvd, Suite 200, Fairfield, CA 94533-4897 | 2009-10-14 |
| 1225264914 | Adam B. Raskin | Internal Medicine | 3000 Mack Rd Ste 100, Fairfield, OH 45014-5335 | 2009-06-08 |
| 1427229160 | The Heart Group | Internal Medicine | 209 Nw 11th St, Fairfield, IL 62837-1218 | 2008-03-21 |
| Find all providers in FAIRFIELD | ||||
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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.