DEACONESS CLINIC, INC
NPI 1104445014
Family Medicine in Henderson, KY

NPI Status: Active since April 10, 2020

Contact Information

471 KLUTEY PARK PLAZA DR
HENDERSON, KY
ZIP 42420
Phone: (270) 830-6100
Fax: (270) 826-3089

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 18D2162097
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-14-2027

About DEACONESS CLINIC, INC

This page provides the complete NPI Profile along with additional information for Deaconess Clinic, Inc, a primary care provider established in Henderson, Kentucky operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1104445014 assigned on April 2020. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Deaconess Clinic, Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Cheryl Annette Wathen (Cfo)

NPI
1104445014
Provider Name
DEACONESS CLINIC, INC
Entity Type
Organization
Location Address
471 KLUTEY PARK PLAZA DR HENDERSON, KY 42420
Location Phone
(270) 830-6100
Location Fax
(270) 826-3089
Mailing Address
PO BOX 1510 EVANSVILLE, IN 47706
Mailing Phone
(812) 450-6815
Mailing Fax
(270) 826-3089
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-10-2020
Last Update Date
04-10-2020
Code Navigator

A primary care provider (PCP) like Deaconess Clinic, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

 
2363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

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

  • Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Catastrophic Essential (+ Incentives) - HMO
  • Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
  • Anthem Silver Essential 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO

*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

CHERYL ANNETTE WATHEN

Authorized Official Title
CFO
Authorized Official Phone
(812) 450-3296

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
18D2162097
Facility Type
Physician Office
Certificate Effective Date
February 15, 2025
Certificate Expiration Date
February 14, 2027
Laboratory Director
DR. CHARLES H. FUTRELL
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Deaconess Clinic, Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate 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 1104445014, we treat the final digit (4) 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 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

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
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
1
Doubled → 2
Check
4
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 0 → 0 4 → 8 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 0 + 4 + 8 + 4 + 1 + 0 + 0 + 2 + 24 = 46

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

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1104445014.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Physical Therapist (Orthopedic)
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Nurse Practitioner (Family)
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Orthopaedic Surgery
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Orthopaedic Surgery
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Orthopaedic Surgery
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Family Medicine
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Nurse Practitioner (Family)
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Family Medicine
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420
Orthopaedic Surgery
471 KLUTEY PARK PLAZA DR
HENDERSON, KY 42420

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104445014, enumerated as an "organization" on April 10, 2020.

The provider is located at 471 KLUTEY PARK PLAZA DR HENDERSON, KY 42420 and the phone number is (270) 830-6100.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.