DEACONESS MEDICAL GROUP - PRINCETON
NPI 1023052883
Internal Medicine in Princeton, IN

NPI Status: Active since June 15, 2006

Contact Information

105 N 2ND AVE
PRINCETON, IN
ZIP 47670
Phone: (812) 386-6560
Fax: (812) 385-5015

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  • Organization
  • Internal Medicine
  • CLIA Number: 15D0361330
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 01-02-2027

About DEACONESS MEDICAL GROUP - PRINCETON

This page provides the complete NPI Profile along with additional information for Deaconess Medical Group - Princeton, an internist established in Princeton, Indiana operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1023052883 assigned on June 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 19 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Deaconess Medical Group - Princeton. The authorized official of this NPI record is Richard M Stivers (Sr Vice President, Cfo)

NPI
1023052883
Provider Legal Name
DEACONESS HOSPITAL, INC
Other Organization Name
DEACONESS MEDICAL GROUP - PRINCETON
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
105 N 2ND AVE PRINCETON, IN 47670
Location Phone
(812) 386-6560
Location Fax
(812) 385-5015
Mailing Address
PO BOX 3407 EVANSVILLE, IN 47733
Mailing Phone
(812) 450-6815
Mailing Fax
(812) 385-5015
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-15-2006
Last Update Date
10-19-2007
Code Navigator

An internist like Deaconess Medical Group - Princeton is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RICHARD M STIVERS

Authorized Official Title
SR VICE PRESIDENT, CFO
Authorized Official Phone
(812) 450-3296

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
CG1119OTHER (01)INRR MCARE GROUP #
182780MEDICARE ID-TYPE UNSPECIFIED (04)IN 
CG1119MEDICARE PIN (08)IN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D0361330
Facility Type
Hospital
Certificate Effective Date
January 03, 2025
Certificate Expiration Date
January 02, 2027
Laboratory Director
JEREMY BIGGE
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Deaconess Medical Group - Princeton on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023052883, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
2
Doubled → 4
Pos 8
8
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 0 + 5 + 4 + 8 + 1 + 6 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1023052883.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Internal Medicine
105 N 2ND AVE
PRINCETON, IN 47670
Urology
105 N 2ND AVE
PRINCETON, IN 47670

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023052883, enumerated as an "organization" on June 15, 2006.

The provider is located at 105 N 2ND AVE PRINCETON, IN 47670 and the phone number is (812) 386-6560.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.