ST MARY'S MEDICAL GROUP, LLC (NPI# 1164852539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164852539 |
| Entity Type | Organization |
| Organization Name | ST MARY'S MEDICAL GROUP, LLC |
| Other Organization Name | ST VINCENT EVANSVILLE MEDICAL GROUP |
| Practice Address |
3700 Washington Ave Evansville IN 47750-0001 |
| Mailing Address |
Po Box 13059 Belfast ME 04915-4021 |
| Practice Telephone | 8124854000 |
| Mailing Telephone | 3175833022 |
| Mailing Fax Number | 3175832199 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2020-02-12 |
| Authorized Official Name | BRIAN MORRIS (CFO (SVMG)) |
| Authorized Official Telephone | 3173386234 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2080S0012X |
Pediatrics Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| 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 | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| ASCENSION MEDICAL GROUP ST. VINCENT EVANSVILLE | Doing Business As Name - Organization |
| St Vincent Evansville Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669939617 | St Mary's Medical Group, LLC | Clinic/Center | 801 St. Marys Drive #406e, Evansville, IN 47714-0524 | 2019-02-26 |
| 1154933703 | St Mary's Medical Group, LLC | Podiatrist | 3801 Bellemeade Ave Ste 110, Evansville, IN 47714-0111 | 2020-08-17 |
| 1619307873 | St Mary's Medical Group, LLC | Obstetrics & Gynecology | 3700 Washington Ave, Evansville, IN 47750-0001 | 2013-11-25 |
| Street Address |
3700 WASHINGTON AVE |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47750-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509115 | Teresa M. Brown | Obstetrics & Gynecology | 3700 Washington Ave, Ste 2200, Evansville, IN 47714-0541 | 2005-06-22 |
| 1003417064 | Kelli Robertson | Dietitian, Registered | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-11-05 |
| 1700409323 | Madeline Eisenhut | Pharmacist | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-05-19 |
| 1023647872 | Alexa Raenae Antrim | Physician Assistant | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-04-03 |
| 1104452077 | Swetha Chenna | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-23 |
| 1902432883 | Jacob Konrad Weinzapfel | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-23 |
| 1235765272 | Troy Manz | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1740816784 | Christopher C Shrack | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1245866185 | Neil Patrick Corbett | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1225664253 | Kengo Zaven Soghoyan | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245270115 | Philip J Kline | Anesthesiology | 370 Wasington Ave, St Marys Medical Center Anesthesea Dept, Evansville, IN 47750 | 2006-06-07 |
| 1649218108 | Scott Hardigree | Anesthesiology | 3700 Wasington Ave, St Marys Medical Center Anesthesea Dept, Evansville, IN 47750 | 2006-06-04 |
| 1891281341 | Claudia Ring | Physical Therapist | 3700 Washington Avenue, Evansville, IN 47750 | 2018-07-09 |
| 1144342965 | Linda Humphrey | Dietitian, Registered | 901 St Mary S Dr, Evansville, IN 47750-0001 | 2007-04-04 |
| 1073655767 | Connie Stachowski | Dietitian, Registered | Joslin Diabetes Center At St Mary's, 3700 Washington Avenue, Evansville, IN 47750-0001 | 2007-02-12 |
| 1265511323 | Regina Elizabeth Auth | Obstetrics & Gynecology | Saint Marys Medical Ctr, 3700 Washington Avenue, Evansville, IN 47750-0001 | 2006-11-02 |
| 1063451946 | Emergency Medicine Physicians of Vanderburgh County, PC | Emergency Medicine | 3500 Washington Ave, Evansville, IN 47750-0001 | 2006-06-06 |
| 1902896582 | Nicole Stiles Gill | Genetic Counselor, MS | 3700 Washington Ave., Suite 2100a, Evansville, IN 47750-0001 | 2005-10-25 |
| 1962496661 | Susanna R Burkhead | Pediatrics | 3700 Washington Avenue, Evansville, IN 47750-0001 | 2005-09-08 |
| 1770729220 | Rippergerm.d.,llc | Obstetrics & Gynecology | 3700 Washington Ave Ste 2200, Evansville, IN 47750-0001 | 2009-01-05 |
| Find all providers in zip 47750 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104317346 | Tri State Community Clinic, LLC | Family Medicine | 1033 E Mt. Pleasant Rd., Ste. D., Evansville, IN 47725 | 2018-05-23 |
| 1528557840 | Deaconess Clinic, Inc. | Family Medicine | 2007 W Franklin St Ste B, Evansville, IN 47712 | 2018-05-02 |
| 1598252652 | Herbert Dan Adams | Family Medicine | 501 Wyndclyff Dr, Evansville, IN 47711-2789 | 2018-04-15 |
| 1326568775 | Midwest Scope LLC | Family Medicine | 1401 Professional Blvd Ste 100, Evansville, IN 47714-8011 | 2017-06-26 |
| 1609303015 | Kyle Lemond | Family Medicine | 1000 S Green River Rd, Evansville, IN 47715-6802 | 2017-05-16 |
| 1871944041 | Anne Alexis | Family Medicine | 3801 Bellemeade Ave Ste 200b, Evansville, IN 47714-0114 | 2016-06-28 |
| 1760864987 | Jared D Mitchell | Family Medicine | 14020 Old State Rd Ste 100, Evansville, IN 47725-1121 | 2015-06-24 |
| 1396126710 | Lynniece A Kocher | Family Medicine | 8600 N Kentucky Avenue, Evansville, IN 47722 | 2015-06-11 |
| 1205194677 | Sanders Medical, LLC | Family Medicine | 2516 Washington Ave, Evansville, IN 47714-2404 | 2012-04-24 |
| 1194090308 | Kenneth E Yagodich, Md, PC | Family Medicine | 1200 Heinlein Rd, Evansville, IN 47725-6379 | 2012-03-21 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 47750 |
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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.