DEACONESS CLINC INC (NPI# 1609108976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609108976 |
| Entity Type | Organization |
| Organization Name | DEACONESS CLINC INC |
| Other Organization Name | DEACONESS CLINIC I |
| Practice Address |
813 E 4th St Ste A Mount Vernon IN 47620-2012 |
| Mailing Address |
Po Box 1510 Evansville IN 47706-1510 |
| Practice Telephone | 8128382139 |
| Practice Fax Number | 8128389214 |
| Mailing Telephone | 8128382139 |
| Mailing Fax Number | 8128389214 |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2020-10-27 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200910700 | 05 |
| Other Name | Type Code |
|---|---|
| Deaconess Clinic I | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992344071 | Deaconess Clinc Inc | Internal Medicine | 120 Se 4th St, Evansville, IN 47708-1607 | 2020-01-06 |
| 1518501675 | Deaconess Clinc Inc | Family Medicine | 2242 Us Highway 41 N, Henderson, KY 42420-2375 | 2019-11-01 |
| Street Address |
813 E 4TH ST STE A |
| City | MOUNT VERNON |
| State | IN |
| Zip Code | 47620-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407475627 | Keely Nicole Brown | Nurse Practitioner | 813 E 4th St Ste A, Mount Vernon, IN 47620-2012 | 2020-04-09 |
| 1720485550 | Alyssa Stocke | Physician Assistant | 813 E 4th St Ste A, Mount Vernon, IN 47620-2012 | 2014-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528434024 | Derek M Solomon | Physical Therapist | 526 E 4th St, Mount Vernon, IN 47620 | 2015-08-19 |
| 1225235492 | Michael Constancio Respicio Mahinay Iv | Specialist | 1250 Main St, #1282, Mount Vernon, IN 47620 | 2007-06-29 |
| 1144348145 | Normal Life of Indiana | Intermediate Care Facility, Mentally Retarded | 1410 Clover St, Mt Vernon, IN 47620 | 2007-03-27 |
| 1902842941 | Matthew R Lee | Family Medicine | 1900 West Fourth Street, Suite 4, Mount Vernon, IN 47620 | 2006-06-20 |
| 1467945139 | Shannon Brittany Lee | Registered Nurse | 1900 W 4th St, Mount Vernon, IN 47620 | 2018-06-07 |
| 1235673989 | Rehabfocus LLC | Physical Therapist | 1250 Main St, #1282, Mount Vernon, IN 47620 | 2016-12-15 |
| 1184960007 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1415 Country Club Rd, Mount Vernon, IN 47620 | 2012-12-20 |
| 1629038724 | David J Julian | Family Medicine | 1900 W 4th St, Mt Vernon, IN 47620 | 2006-03-24 |
| 1760891618 | David N. Wells | Dentist | 803 East Fourth Street, Mount Vernon, IN 47620-0673 | 2014-08-05 |
| 1104142918 | David Keith Uebelhack | Dentist | 803 East Fourth St., Mount Vernon, IN 47620-0673 | 2010-04-19 |
| Find all providers in zip 47620 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353464 | Ekaterina Melnik | Nurse Practitioner | 1809 Lindsay Loop, Mount Vernon, WA 98274-6135 | 2020-07-13 |
| 1518520998 | Mary Lynn Peeks | Nurse Practitioner | 4810 Broadway St, Mount Vernon, IL 62864-6752 | 2019-04-21 |
| 1144749748 | Charnell Sue Allan | Nurse Practitioner | 10627 Lawrence 1170, Mount Vernon, MO 65712-8174 | 2017-09-14 |
| 1922550235 | Jas Medical LLC | Nurse Practitioner | 11301 Upper Gilchrist Rd, Mount Vernon, OH 43050-8923 | 2016-11-03 |
| 1427438266 | Petrona Ennis-welch | Nurse Practitioner | 414 Mcclellan Ave Ph, Mount Vernon, NY 10553-2103 | 2015-06-07 |
| 1033292909 | Aundrea F. Pippel | Nurse Practitioner | 208 S 14th St, Mount Vernon, WA 98274-4117 | 2006-10-23 |
| 1215951876 | Lynn M Followell | Nurse Practitioner | 1501 Mcpherson Ave, Mount Vernon, IL 62864-2831 | 2006-07-27 |
| 1649217886 | Stephanie Michele Friess | Nurse Practitioner | 713 1st Ave Nw, Mount Vernon, IA 52314-1478 | 2006-05-31 |
| 1275515363 | Margaret Ruth Aubin | Nurse Practitioner | 205 Stewart Rd, Mount Vernon, WA 98273-9607 | 2005-11-15 |
| 1205821923 | Sharron Gingrich | Nurse Practitioner | 2 Good Samaritan Way Ste 405, Mount Vernon, IL 62864-2478 | 2005-09-19 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 47620 |
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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.