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DEACONESS CLINIC, INC
NPI 1013890250
Nurse Practitioner in Jasper, IN

Active since July 28, 2025CLIA 15D2028612 · Waiver
1025 1ST AVE W, JASPER, IN 47546(812) 559-3000(812) 559-3001 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Deaconess Clinic, Inc NPPES

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

DEACONESS CLINIC, INC (NPI 1013890250) is a healthcare organization registered as a nurse practitioner in Jasper, Indiana and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through August 18, 2027 and lists Cheryl Annette Wathen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1013890250
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameDEACONESS CLINIC, INC
Location Address1025 1ST AVE WJasper, IN 47546-3217
Mailing AddressPo Box 631767Cincinnati, OH 45263-1767 · (812) 450-6815
Phone(812) 559-3000
Fax(812) 559-3001
Organization SubpartNo
Authorized OfficialCheryl Annette WathenCfo · (812) 450-3296
Enumeration DateJuly 28, 2025
NPPES CertifiedJuly 27, 2025
✔ NPI 1013890250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
1025 1ST AVE W, Jasper, IN 47546
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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

CLIA Laboratory Certificates CMS CLIA

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 15D2028612

Deaconess Clinic Jasper Health & Wellness · Jasper, IN
Active · expires Aug 18, 2027
CLIA Number15D2028612
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2025
Certificate Expiration DateAugust 18, 2027
Laboratory DirectorMelinda J. Gruber
Laboratory Phone(812) 996-2399
Laboratory LocationDeaconess Clinic Jasper Health & Wellness1100 W 12th Ave, Jasper, IN 47546
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INNER STRENGTH COUNSELING, LLC
Social Worker (Clinical)
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 630-8580
MELANIE HOPF PA-C
Physician Assistant (Medical)
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 476-7111
MADISON GOGEL PA-C
Physician Assistant
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 476-7111
DEACONESS MEMORIAL MEDICAL CENTER INC
Family Medicine
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 996-8460
DR. TERRY RAY BROWN MD
Obstetrics & Gynecology
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 482-6066
GABRIELLA MAIZEY HAMILTON NP
Nurse Practitioner
1025 1ST AVE W
JASPER, IN 47546
Dubois County (812) 559-3000

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 1013890250. It was assigned to this organization in the NPPES registry on July 28, 2025.

Where is Deaconess Clinic, Inc located?

Deaconess Clinic, Inc is located at 1025 1st Ave W, Jasper, IN 47546. The listed phone number is (812) 559-3000.

What is Deaconess Clinic, Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Deaconess Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2028612) is associated with this NPI, valid through August 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Deaconess Clinic, Inc was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.