DEACONESS CLINIC - MEMORIAL
NPI 1013519396
Clinic/Center in Evansville, IN

Active since November 12, 2020CLIA Certified · 2 labs
645 CONNIE ROBINSON WAY, EVANSVILLE, IN 47713(812) 450-8764(124) 012-1178 Get Directions Write a Review

NPPES record last updated: April 7, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 7, 2021, Feb 2, 2021, Dec 1, 2020 and 1 more (4 updates tracked since 2020).

About Deaconess Clinic - Memorial NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEACONESS CLINIC - MEMORIAL (NPI 1013519396) is a healthcare organization registered as a clinic/center in Evansville, Indiana and active in the NPI registry since November 2020. The organization holds 2 active CLIA laboratory certificates and lists Cheryl Annette Wathen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1013519396
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameDEACONESS CLINIC, INC.
Location Address645 CONNIE ROBINSON WAYEvansville, IN 47713-1822
Mailing AddressPo Box 1510Evansville, IN 47706-1510 · (812) 450-6815 · Fax (812) 450-6822
Fax(124) 012-1178
Organization SubpartNo
Authorized OfficialCheryl Annette WathenCfo · (812) 450-3296
Enumeration DateNovember 12, 2020
Last NPPES UpdateApril 7, 20214 updates tracked since enumeration
NPPES CertifiedApril 7, 2021
✔ NPI 1013519396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
645 CONNIE ROBINSON WAY, Evansville, IN 47713

Other Names 1

Doing Business AsDeaconess Clinic - Memorial

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deaconess Clinic - Memorial is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

444

Medicare enrollment records show 444 clinicians reassign Medicare billing to Deaconess Clinic - Memorial, which bills Medicare for the services they deliver. Of these, 278 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 26

Nurse Practitioner193
Family Practice97
Pediatric Medicine33
Internal Medicine21
Otolaryngology14
Gastroenterology13
Urology9
Endocrinology8
18 other specialties56

Nearest to this location (20)

See all 444
Nurse Practitioner
NPI 1912289489
901 SWEETSER AVE
Evansville, IN 47713
(812) 435-0977
✔ PECOS✔ Accepts Medicare0.5 mi
Internal Medicine
NPI 1174788756
316 CHANDLER AVE
Evansville, IN 47713
(812) 436-4501
✔ PECOS✔ Accepts Medicare0.9 mi
Nurse Practitioner
NPI 1053193532
315 MULBERRY ST
Evansville, IN 47713
(812) 492-8310
✔ PECOS✔ Accepts Medicare0.9 mi
Internal Medicine
NPI 1679886691
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9372
✔ PECOS✔ Accepts Medicare1.2 mi
Gastroenterology
NPI 1326200536
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9545
✔ PECOS✔ Accepts Medicare1.2 mi
Urology
NPI 1891093456
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9855
✔ PECOS✔ Accepts Medicare1.2 mi
Family Practice
NPI 1215138920
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-6645
✔ PECOS✔ Accepts Medicare1.2 mi
Nurse Practitioner
NPI 1053500819
421 CHESTNUT ST
Evansville, IN 47713
(812) 450-8600
✔ PECOS✔ Accepts Medicare1.2 mi
Podiatry
NPI 1730375882
421 CHESTNUT ST
Evansville, IN 47713
(812) 479-6909
✔ PECOS✔ Accepts Medicare1.2 mi
Clinical Social Worker
NPI 1659631836
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9779
✔ PECOS✔ Accepts Medicare1.2 mi
Clinical Psychologist
NPI 1871905356
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9779
✔ PECOS1.2 mi
Allergy/Immunology
NPI 1922175694
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9459
✔ PECOS✔ Accepts Medicare1.2 mi
Dermatology
NPI 1619235306
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9355
✔ PECOS✔ Accepts Medicare1.2 mi
Infectious Disease
NPI 1205065737
520 MARY ST STE 230
Evansville, IN 47710
(812) 450-8600
✔ PECOS✔ Accepts Medicare2.0 mi
Hospice/Palliative Care
NPI 1568401503
520 MARY ST STE 340
Evansville, IN 47710
(812) 450-3201
✔ PECOS✔ Accepts Medicare2.0 mi
Hospitalist
NPI 1376982371
600 MARY ST
Evansville, IN 47710
(812) 450-7338
✔ PECOS✔ Accepts Medicare2.1 mi
Otolaryngology
NPI 1003887563
350 W COLUMBIA ST STE 310
Evansville, IN 47710
(812) 425-2646
✔ PECOS✔ Accepts Medicare2.1 mi
Qualified Audiologist
NPI 1043373319
350 W COLUMBIA ST
Evansville, IN 47710
(812) 425-2646
✔ Accepts Medicare2.1 mi
Neurology
NPI 1093719841
801 SAINT MARYS DR STE 303
Evansville, IN 47714
(812) 477-1560
✔ PECOS✔ Accepts Medicare3.1 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1265769137
3900 WASHINGTON AVE STE 100
Evansville, IN 47714
(812) 485-6694
3.1 mi
See all 444 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2215179

Deaconess Clinic Memorial · Evansville, IN
Active · expires Nov 30, 2026
CLIA Number15D2215179
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorDr. Pearl Quartey
Laboratory Phone(812) 450-8764
Laboratory LocationDeaconess Clinic Memorial645 Connie Robinson Way, Evansville, IN 47713
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2013545

Deaconess Clinic Downtown · Evansville, IN
Active · expires Jul 14, 2028
CLIA Number15D2013545
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorWilliam Smith
Laboratory Phone(812) 492-5122
Laboratory LocationDeaconess Clinic Downtown120 SE 4th St, Evansville, IN 47713
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deaconess Clinic, Inc.'s NPI number?

The NPI number for Deaconess Clinic, Inc. is 1013519396. It was assigned to this organization in the NPPES registry on November 12, 2020. The provider is doing business as Deaconess Clinic - Memorial.

Where is Deaconess Clinic, Inc. located?

Deaconess Clinic, Inc. is located at 645 Connie Robinson Way, Evansville, IN 47713. The listed phone number is (812) 450-8764.

What is Deaconess Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Deaconess Clinic, Inc. enrolled in Medicare?

Yes. Deaconess Clinic, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Deaconess Clinic, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 444 clinicians in 26 Medicare specialties reassign their Medicare billing to Deaconess Clinic, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (193), Family Practice (97) and Pediatric Medicine (33). Of these, 278 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Deaconess Clinic, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Deaconess Clinic, Inc. accept?

Health plans from Anthem Blue Cross and Blue Shield list Deaconess Clinic, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deaconess Clinic, Inc. was last updated on April 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.