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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: August 09, 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
Phone(812) 450-8764
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
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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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

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.

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 Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian 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.