DEACONESS HOSPITAL, INC (NPI# 1750399259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750399259 |
| Entity Type | Organization |
| Organization Name | DEACONESS HOSPITAL, INC |
| Other Organization Name | DEACONESS PRIMARY CARE FOR SENIORS - NORTH |
| Practice Address |
4498 N 1st Ave Evansville IN 47710-3622 |
| Mailing Address |
Po Box 3407 Evansville IN 47733-3407 |
| Practice Telephone | 8124367280 |
| Practice Fax Number | 8124367290 |
| Mailing Telephone | 8124506815 |
| Mailing Fax Number | 8124506822 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-07-03 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200180960A | 05 | |
| IN | RR MCARE GROUP # | CG1119 | 01 |
| Other Name | Type Code |
|---|---|
| Deaconess Primary Care for Seniors - North | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174007132 | Deaconess Hospital, Inc | Social Worker | 4133 Gateway Blvd Ste 290, Newburgh, IN 47630-7918 | 2018-09-17 |
| 1801313002 | Deaconess Hospital, Inc | Pharmacy | 4209 Gateway Blvd., Newburgh, IN 47630 | 2017-08-28 |
| 1033643010 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 1416 W. Broadway St, Princeton, IN 47670 | 2017-04-17 |
| 1528456522 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 2017 N Green River Rd, Evansville, IN 47715-1909 | 2014-12-30 |
| 1154577609 | Deaconess Hospital, Inc | Nurse Practitioner | 10455 Orthopaedic Drive, Newburgh, IN 47630 | 2008-08-15 |
| 1902985096 | Deaconess Hospital, Inc | Counselor | 209 N Elm St, Henderson, KY 42420-3132 | 2006-11-02 |
| 1598844680 | Deaconess Hospital, Inc | Counselor | 2792 N Us Highway 231, Rockport, IN 47635-8883 | 2006-11-02 |
| 1841303484 | Deaconess Hospital, Inc | Psychologist | 920 Frederica St Ste 1003, Owensboro, KY 42301-3075 | 2006-08-17 |
| 1821038316 | Deaconess Hospital, Inc | Family Medicine | 4600 W Lloyd Expy, Evansville, IN 47712-6517 | 2006-06-07 |
| 1861498529 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 701 Garfield Ave, Evansville, IN 47710-1771 | 2005-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEACONESS HOSPITAL, INC. | 600 Mary St, Evansville, IN 47747 |
| Street Address |
4498 N 1ST AVE |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47710-3622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659372332 | Vickie L Bush | Nurse Practitioner | 4498 N 1st Ave, Evansville, IN 47710-3622 | 2005-08-03 |
| 1518062819 | Azizullah Mehrzad | Internal Medicine | 4498 N 1st Ave, Evansville, IN 47710-3622 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659860971 | Deaconess Clinic, Inc. | Clinic/Center | 309 N 1st Ave, Evansville, IN 47710 | 2018-05-02 |
| 1558858852 | Amanda Marie Fox | Nurse Practitioner | 3838 N 1st Ave Ste E, Evansville, IN 47710 | 2018-04-23 |
| 1255708723 | Peter Wulff | Dentist | 350 W Columbia St Ste 1-d, Evansville, IN 47710 | 2015-08-31 |
| 1427483999 | Deanna Lynne Plummer | Nurse Practitioner | 4480 First Avenue, Evansville, IN 47710 | 2013-09-03 |
| 1124371067 | Michael Wayne Daugherty | Radiology | 350 W Columbia St Ste 420, Evansville, IN 47710 | 2012-10-16 |
| 1316249105 | Melisha Victoria Knowlden | Counselor | 1333 W. Mill Rd, Suite #204, Evansville, IN 47710 | 2010-11-30 |
| 1609057835 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 621 W Columbia St, Evansville, IN 47710 | 2007-11-15 |
| 1023161478 | Janet Marie Kelley | Family Medicine | 3838 N 1st Ave Ste C, Evansville, IN 47710 | 2007-01-19 |
| 1164594545 | John David Diekmann | Dentist | 625 W Mill Rd, Evansville, IN 47710 | 2006-11-14 |
| 1407930977 | Allan C Knapp Dds LLC | Dentist | 3012 N First Ave, Evansville, IN 47710 | 2006-10-24 |
| Find all providers in zip 47710 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1518062819 | Azizullah Mehrzad | Internal Medicine | 4498 N 1st Ave, Evansville, IN 47710-3622 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560491 | Advanced Medical Strategies LLC | Internal Medicine | 3646 Wirth Rd, Highland, IN 46322-2218 | 2020-08-28 |
| 1508309295 | M Care Pllc | Internal Medicine | 443 Spring St Ste 2, Jeffersonville, IN 47130-4495 | 2016-11-29 |
| 1982054664 | Tooba Tariq | Internal Medicine | 720 Eskenazi Ave Ste F2-600, Indianapolis, IN 46202-5187 | 2016-06-14 |
| 1154663763 | Alexander C. Gatzimos Md Jd | Internal Medicine | 2050 E Ireland Rd, South Bend, IN 46614-2909 | 2013-03-21 |
| 1962717348 | Neshahthari Wijeyakuhan | Internal Medicine | 1400 N Ritter Ave Ste 231, Indianapolis, IN 46219-3099 | 2010-08-10 |
| 1972741338 | Duan Lamont Pierce | Internal Medicine | 1333 Walston Ct, Indianapolis, IN 46260-3371 | 2009-01-22 |
| 1063659688 | Tochukwu C Iloabuchi | Internal Medicine | 6677 W May Apple Dr, Mccordsville, IN 46055-4447 | 2009-01-20 |
| 1073783627 | Dr Housecall | Internal Medicine | 4008 E New York St, Indianapolis, IN 46201-3662 | 2008-03-10 |
| 1275667677 | Wound Care Specialists of Indiana PC | Internal Medicine | 1200 W Carmel Dr Ste 103, Carmel, IN 46032-8707 | 2007-03-15 |
| 1417082520 | Jeff C Darnell | Internal Medicine | 3829 East 126th Street, Carmel, IN 46033-3151 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
| City | EVANSVILLE |
| Zip Code | 47710 |
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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.