DEACONESS CLINIC, INC (NPI# 1356577985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356577985 |
| Entity Type | Organization |
| Organization Name | DEACONESS CLINIC, INC |
| Other Organization Name | DEACONESS CLINIC II |
| Practice Address |
4055 Gateway Blvd Newburgh IN 47630-8947 |
| Mailing Address |
Po Box 3868 Evansville IN 47737-3868 |
| Practice Telephone | 8128423051 |
| Practice Fax Number | 8128583060 |
| Mailing Telephone | 8128583051 |
| Mailing Fax Number | 8124269503 |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2020-06-03 |
| 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 | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| 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 | 364S00000X | Clinical Nurse Specialist | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Deaconess Clinic II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861961138 | Deaconess Clinic, Inc | Physician Assistant | 350 W Columbia St Ste 440, Evansville, IN 47710-1782 | 2018-11-16 |
| 1225468937 | Deaconess Clinic, Inc | Allergy & Immunology | 4840 S Maple Tree Dr, Princeton, IN 47670-9277 | 2013-11-15 |
| 1396040374 | Deaconess Clinic, Inc | Physician Assistant | 1204 Williams St., Oakland City, IN 47660-1001 | 2011-01-21 |
| 1043466329 | Deaconess Clinic, Inc | Pediatrics | 15814 Neeley St, Evansville, IN 47725-8420 | 2008-08-18 |
| 1306092192 | Deaconess Clinic, Inc | Internal Medicine | 1300 Merritt Dr, Henderson, KY 42420-2788 | 2008-08-12 |
| 1528214400 | Deaconess Clinic, Inc | Psychologist | 685 Vail Street, Princeton, IN 47670-9510 | 2008-08-12 |
| 1407804602 | Deaconess Clinic, Inc | Family Medicine | 10455 Orthopaedic Dr, Newburgh, IN 47630-7955 | 2006-05-04 |
| 1447862958 | Deaconess Clinic, Inc | Nurse Practitioner | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2020-08-18 |
| 1982216495 | Deaconess Clinic, Inc | Nurse Practitioner | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2020-08-18 |
| 1790397206 | Deaconess Clinic, Inc | Nurse Practitioner | 312 3rd Ave, Princeton, IN 47670-1014 | 2020-08-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEACONESS CLINIC, INC. | 421 Chestnut St, Evansville, IN 47713-1227 |
| Street Address |
4055 GATEWAY BLVD |
| City | NEWBURGH |
| State | IN |
| Zip Code | 47630-8947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003875964 | Kelli Shea Dempsey | Nurse Practitioner | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2006-03-20 |
| 1558912790 | Heidi Hendryx | Physician Assistant | 4055 Gateway Blvd, Newburgh, IN 47630 | 2019-09-27 |
| 1114315116 | Lauren Richardson | Physician Assistant | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2014-12-30 |
| 1124362538 | Audrey B Cornelius | Physician Assistant | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2012-11-26 |
| 1043540628 | Rachel Ann Cron | Physician Assistant | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2010-01-05 |
| 1750556684 | Amy M Braden | Internal Medicine | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2008-04-22 |
| 1588875009 | Samer I. Schuman | Obstetrics & Gynecology | 4055 Gateway Blvd, Newburgh, IN 47630 | 2007-05-25 |
| 1497835680 | Christopher David Braden | Internal Medicine | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2006-10-16 |
| 1881635118 | Manga Devi Kodali | Internal Medicine | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2006-06-09 |
| 1679532600 | Daniel Ray Shirey | Internal Medicine | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2006-03-20 |
| 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 | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386805307 | Vivian C Cook | Internal Medicine | 3699 Epworth Road, Newburgh, IN 47630-8909 | 2008-06-23 |
| 1902957384 | Umangi M Patel | Internal Medicine | 611 Gidney Ave, Newburgh, NY 12550-2823 | 2007-01-14 |
| 1174639751 | Fauzia Paracha | Internal Medicine | 5109 Route 9w Ste 2, Newburgh, NY 12550-1945 | 2006-08-23 |
| 1659344117 | Anthony W Stephens | Internal Medicine | 3699 Epworth Rd, Suite 110, Newburgh, IN 47630-8909 | 2006-02-07 |
| 1093127557 | Leslie Rae Pike Brown | Internal Medicine | 3699 Epworth Rd, Newburgh, IN 47630-8909 | 2014-06-02 |
| 1275868150 | Comprehensive Blood &cancer Medical Care,pc | Internal Medicine | 5109 Route 9w, Suite 2, Newburgh, NY 12550-1952 | 2009-10-09 |
| 1750556684 | Amy M Braden | Internal Medicine | 4055 Gateway Blvd, Newburgh, IN 47630-8947 | 2008-04-22 |
| 1710150222 | Oncology Hematology Associates, PC | Internal Medicine | 3699 Epworth Rd, Newburgh, IN 47630 | 2008-04-04 |
| 1619159852 | Marc G Rappaport | Internal Medicine | 1200 Route 300, Newburgh, NY 12550-5003 | 2007-11-29 |
| 1033260419 | Mid Valley Oncology Hematology, P.C. | Internal Medicine | 611 Gidney Ave, Newburgh, NY 12550-2823 | 2007-01-14 |
| 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.