DEACONESS CLINC INC
NPI 1053077107
Dermatology in Madisonville, KY

Active since November 12, 2021
1851 N MAIN ST, MADISONVILLE, KY 42431(812) 450-6859 Get Directions Write a Review

NPPES record last updated: November 12, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Deaconess Clinc Inc NPPES

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

DEACONESS CLINC INC (NPI 1053077107), doing business as Deaconess Clinic Dermatology Madisonville, is a healthcare organization registered as a dermatology in Madisonville, Kentucky and active in the NPI registry since November 2021. The organization lists Cheryl Annette Wathen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1053077107
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDEACONESS CLINC INC
Location Address1851 N MAIN STMadisonville, KY 42431-9024
Mailing AddressPo Box 1510Evansville, IN 47706-1510 · (812) 450-6815 · Fax (812) 450-6822
Organization SubpartNo
Authorized OfficialCheryl Annette WathenCfo · (812) 450-3296
Enumeration DateNovember 12, 2021
NPPES CertifiedNovember 12, 2021
✔ NPI 1053077107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedNurse PractitionerTaxonomy 363L00000X
1851 N MAIN ST, Madisonville, KY 42431

Other Names 1

Doing Business AsDeaconess Clinic Dermatology Madisonville

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 Clinc Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

174

Medicare enrollment records show 174 clinicians reassign Medicare billing to Deaconess Clinc Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 16

Nurse Practitioner102
Family Practice28
Internal Medicine7
Gastroenterology6
Pediatric Medicine6
Infectious Disease4
Nephrology4
Urology4
8 other specialties13

Nearest to this location (20)

See all 174
Family Practice
NPI 1659893337
1851 N MAIN ST
Madisonville, KY 42431
(270) 825-7268
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1366811796
215 E MAIN ST
Providence, KY 42450
(270) 667-7017
✔ PECOS✔ Accepts Medicare15 mi
Nurse Practitioner
NPI 1043640659
121 E MAIN ST
Providence, KY 42450
(270) 667-2023
✔ PECOS✔ Accepts Medicare15 mi
Family Practice
NPI 1588638969
121 E MAIN ST
Providence, KY 42450
(270) 667-2023
✔ PECOS✔ Accepts Medicare15 mi
Nurse Practitioner
NPI 1851549711
121 E MAIN ST
Providence, KY 42450
(270) 667-2023
✔ PECOS✔ Accepts Medicare15 mi
Nurse Practitioner
NPI 1043964927
1355 US HIGHWAY 41A S
Dixon, KY 42409
(270) 639-9101
✔ PECOS✔ Accepts Medicare19 mi
Family Practice
NPI 1336757152
1355 US HIGHWAY 41A S
Dixon, KY 42409
(270) 639-9101
✔ PECOS✔ Accepts Medicare19 mi
Nurse Practitioner
NPI 1649785759
7139 STATE ROUTE 56 E
Sebree, KY 42455
(270) 318-5088
✔ PECOS✔ Accepts Medicare21 mi
Nurse Practitioner
NPI 1609330273
47 W WEBSTER STREET
Sebree, KY 42455
(270) 835-7541
✔ PECOS✔ Accepts Medicare21 mi
Nurse Practitioner
NPI 1841234051
9064 US HWY 60 W
Sturgis, KY 42459
(270) 333-4349
✔ PECOS31 mi
Family Practice
NPI 1275159337
105 KEETON DR
Hopkinsville, KY 42240
(270) 887-6565
✔ PECOS✔ Accepts Medicare33 mi
Internal Medicine
NPI 1275537243
1700 US HIGHWAY 60 W
Morganfield, KY 42437
(270) 389-0031
✔ PECOS34 mi
Pediatric Medicine
NPI 1821155532
110 3RD ST SUITE 180
Henderson, KY 42420
(270) 827-3573
✔ PECOS37 mi
Podiatry
NPI 1679198436
736 N ELM ST
Henderson, KY 42420
(270) 827-7199
✔ PECOS✔ Accepts Medicare38 mi
Allergy/Immunology
NPI 1639376296
2851 NEW HARTFORD RD
Owensboro, KY 42303
(270) 228-2811
✔ PECOS✔ Accepts Medicare38 mi
Gastroenterology
NPI 1639584014
1305 N ELM ST STE G
Henderson, KY 42420
(812) 426-9545
✔ PECOS✔ Accepts Medicare38 mi
Neurology
NPI 1093719841
801 SAINT MARYS DR STE 303
Evansville, IN 47714
(812) 477-1560
✔ PECOS✔ Accepts Medicare46 mi
Hematology/Oncology
NPI 1023022118
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9411
✔ PECOS✔ Accepts Medicare46 mi
Nephrology
NPI 1255581641
421 CHESTNUT ST
Evansville, IN 47713
(812) 492-5202
✔ PECOS✔ Accepts Medicare46 mi
Urology
NPI 1891093456
421 CHESTNUT ST
Evansville, IN 47713
(812) 426-9855
✔ PECOS✔ Accepts Medicare46 mi
See all 174 clinicians

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

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 Clinc Inc's NPI number?

The NPI number for Deaconess Clinc Inc is 1053077107. It was assigned to this organization in the NPPES registry on November 12, 2021. The provider is doing business as Deaconess Clinic Dermatology Madisonville.

Where is Deaconess Clinc Inc located?

Deaconess Clinc Inc is located at 1851 N Main St, Madisonville, KY 42431. The listed phone number is (812) 450-6859.

What is Deaconess Clinc Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Deaconess Clinc Inc enrolled in Medicare?

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

How many clinicians bill Medicare through Deaconess Clinc Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 174 clinicians in 16 Medicare specialties reassign their Medicare billing to Deaconess Clinc 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 (102), Family Practice (28) and Internal Medicine (7). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Deaconess Clinc Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Cigna Healthcare list Deaconess Clinc 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 Clinc Inc was last updated on November 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.