DEACONESS CLINIC, INC
NPI 1104445014
Family Medicine in Henderson, KY
About Deaconess Clinic, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEACONESS CLINIC, INC (NPI 1104445014), doing business as Deaconess Clinic Klutey Park, is a healthcare organization registered as a family medicine in Henderson, Kentucky and active in the NPI registry since April 2020. The organization holds a CLIA Microscopy certificate valid through February 14, 2027 and lists Cheryl Annette Wathen, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
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, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
174Medicare enrollment records show 174 clinicians reassign Medicare billing to Deaconess Clinic, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 62 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 16
Nearest to this location (20)
See all 174Source: 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
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 for Provider-Performed Microscopy Procedures (PPMP) 18D2162097
Deaconess Clinic Klutey Park · Henderson, KYFrequently 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 1104445014. It was assigned to this organization in the NPPES registry on April 10, 2020. The provider is doing business as Deaconess Clinic Klutey Park.
Where is Deaconess Clinic, Inc located?
Deaconess Clinic, Inc is located at 471 Klutey Park Plaza Dr, Henderson, KY 42420. The listed phone number is (270) 830-6100.
What is Deaconess Clinic, Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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), 174 clinicians in 16 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 (102), Family Practice (28) and Internal Medicine (7). Of these, 2 practice at this address and 62 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Deaconess Clinic, Inc hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 18D2162097) is associated with this NPI, valid through February 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Deaconess Clinic, Inc accept?
Health plans from Anthem Blue Cross and Blue Shield and Cigna Healthcare 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 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Deaconess Clinic, Inc · NPI 1104445014
Family Medicine organization in Henderson, Kentucky. Organization record, active in the CMS NPPES registry since April 10, 2020.
## Identity
- **NPI:** 1104445014 (Entity type: Organization)
- **Enumerated:** April 10, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Deaconess Clinic Klutey Park (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Cheryl Wathen, CFO
## Practice location
- **Address:** 471 KLUTEY PARK PLAZA DR, Henderson, KY 42420-3347
- **Phone:** (270) 830-6100 · **Fax:** (270) 826-3089
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 174 clinicians in 16 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (102), Family Practice (28), Internal Medicine (7); 2 practice at this address and 62 within 10 miles; [full list](https://npiprofile.com/npi/1104445014/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 10, 2020
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1104445014) · Data from the CMS NPPES public registry.