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DEACONESS HOSPITAL INC NPI 1205864287


NPI Information

NPI: 1205864287
Provider Name: DEACONESS HOSPITAL, INC

Doing Business As: DEACONESS MEDICAL GROUP - PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 15D0918500

Address:
4111 GATEWAY BLVD
NEWBURGH, IN
ZIP 47630
Phone: (812) 853-5300
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DEACONESS HOSPITAL, INC is a pediatrics in Newburgh, IN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DEACONESS HOSPITAL, INC NPI is 1205864287. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Deaconess Medical Group - Pediatrics.

The provider's business location address is:

4111 GATEWAY BLVD
NEWBURGH, IN
ZIP 47630-954
Phone: (812) 853-5300
Fax: (812) 858-4656

The provider's authorized official is Richard M Stivers .
The authorized official title is Sr Vice President, Cfo and has the following contact phone number (812) 450-3296.

The CLIA number assigned to this NPI record is 15D0918500 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2006 and was last updated on 12/20/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CG1119OTHERINDIANARR MCARE GROUP #
2191410MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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