DEACONESS CLINIC, INC. (NPI# 1740899236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740899236 |
| Entity Type | Organization |
| Organization Name | DEACONESS CLINIC, INC. |
| Practice Address |
4144 Wyntree Dr Newburgh IN 47630-2521 |
| Mailing Address |
Po Box 1510 Evansville IN 47706-1510 |
| Practice Telephone | 8128581957 |
| Practice Fax Number | 8128581917 |
| Mailing Telephone | 8124506815 |
| Mailing Fax Number | 8124506822 |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | CHERYL ANNETTE WATHEN (CFO) |
| Authorized Official Telephone | 8124503296 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Deaconess Clinic - Wyntree | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306492160 | Deaconess Clinic, Inc. | Clinic/Center | 315 N 1st Ave, Evansville, IN 47710-1218 | 2019-08-16 |
| 1437639119 | Deaconess Clinic, Inc. | Nurse Practitioner | 2100 N Fulton Ave, Evansville, IN 47710-2842 | 2018-08-21 |
| 1649750514 | Deaconess Clinic, Inc. | Nurse Practitioner | 2000 Lodge Ave, Evansville, IN 47714-4261 | 2018-08-20 |
| 1659860971 | Deaconess Clinic, Inc. | Clinic/Center | 309 N 1st Ave, Evansville, IN 47710 | 2018-05-02 |
| 1528557840 | Deaconess Clinic, Inc. | Family Medicine | 2007 W Franklin St Ste B, Evansville, IN 47712 | 2018-05-02 |
| 1285039420 | Deaconess Clinic, Inc. | Physician Assistant | 1414 W Broadway St, Princeton, IN 47670-1142 | 2014-10-30 |
| 1003211244 | Deaconess Clinic, Inc. | Audiologist | 350 W Columbia St Ste 200, Evansville, IN 47710-1782 | 2014-10-30 |
| 1457952996 | Deaconess Clinic, Inc. | Clinic/Center | 3434 W State Road 66, Rockport, IN 47635-9259 | 2020-11-02 |
| 1023644838 | Deaconess Clinic, Inc. | Nurse Practitioner | 1000 S Green River Rd, Evansville, IN 47715-6802 | 2020-03-13 |
| 1295391480 | Deaconess Clinic, Inc. | Family Medicine | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-05-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEACONESS CLINIC, INC. | 421 Chestnut St, Evansville, IN 47713-1227 |
| Street Address |
4144 WYNTREE DR |
| City | NEWBURGH |
| State | IN |
| Zip Code | 47630-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558332734 | Melinda Brown Jackson | Family Medicine | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2006-01-27 |
| 1659813160 | Rose Angela Coslett | Nurse Practitioner | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2016-11-15 |
| 1700250867 | Brandi Annette Eyer | Nurse Practitioner | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2015-11-30 |
| 1962827345 | Anna Kavanaugh | Nurse Practitioner | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2014-02-21 |
| 1477989861 | Ashley Nicole Lampton | Nurse Practitioner | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2013-09-18 |
| 1700064797 | Melinda Jackson Md Phd | Nurse Practitioner | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2008-02-01 |
| 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 | 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 |
|---|---|---|---|---|
| 1093874620 | Annie Samina Aziz | Family Medicine | 200 Lake Street, Newburgh, NY 12550-5243 | 2006-12-08 |
| 1336212331 | Clovis E Manley | Family Medicine | 4943 Rosebud Ln, Newburgh, IN 47630-9226 | 2006-11-16 |
| 1417050089 | James Darrigo | Family Medicine | 38 North Plank Rd, Newburgh, NY 12550 | 2006-09-07 |
| 1831101757 | Anjali N Shah | Family Medicine | 310 Fullerton Ave, Suite 101, Newburgh, NY 12550-3724 | 2006-08-12 |
| 1407804602 | Deaconess Clinic, Inc | Family Medicine | 10455 Orthopaedic Dr, Newburgh, IN 47630-7955 | 2006-05-04 |
| 1558332734 | Melinda Brown Jackson | Family Medicine | 4144 Wyntree Dr, Newburgh, IN 47630-2521 | 2006-01-27 |
| 1114904380 | Carleen M Rubel | Family Medicine | 3799 Venetian Way, Newburgh, IN 47630-8278 | 2005-12-28 |
| 1396722757 | Harry C Harvey | Family Medicine | 8077 Rose Hill Dr, Newburgh, IN 47630-2811 | 2005-12-28 |
| 1073598330 | Jon Scott Uloth | Family Medicine | 3711 Casey Rd, Newburgh, IN 47630-8343 | 2005-12-09 |
| 1841273968 | Krishna R. Chilukuri | Family Medicine | 4166 Wyntree Dr, Suite A, Newburgh, IN 47630-2521 | 2005-11-22 |
| 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.