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DEACONESS CLINIC, INC
NPI 1174026363
Clinic/Center in Boonville, IN

Active since March 14, 2018CLIA 15D2144696 · Waiver
930 W MAIN ST, BOONVILLE, IN 47601(812) 641-0088(812) 641-0092 Get Directions Write a Review

NPPES record last updated: March 14, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Deaconess Clinic, Inc NPPES

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

DEACONESS CLINIC, INC (NPI 1174026363) is a healthcare organization registered as a clinic/center in Boonville, Indiana and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through February 20, 2028 and lists Cheryl Annette Wathen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1174026363
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameDEACONESS CLINIC, INC
Location Address930 W MAIN STBoonville, IN 47601-1591
Mailing AddressPo Box 1510Evansville, IN 47706-1510 · (812) 641-0088 · Fax (812) 641-0092
Phone(812) 641-0088
Fax(812) 641-0092
Organization SubpartNo
Authorized OfficialCheryl Annette WathenCfo · (812) 450-3296
Enumeration DateMarch 14, 2018
✔ NPI 1174026363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
930 W MAIN ST, Boonville, IN 47601
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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 15D2144696

Deaconess Clinic At Work Boonville · Boonville, IN
Active · expires Feb 20, 2028
CLIA Number15D2144696
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorScott Uloth
Laboratory Phone(812) 641-0088
Laboratory LocationDeaconess Clinic At Work Boonville930 W Main St, Boonville, IN 47601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

KAITLYN NICOLE HALBIG NP
Nurse Practitioner
930 W MAIN ST
BOONVILLE, IN 47601
Warrick County (812) 490-0283

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 1174026363. It was assigned to this organization in the NPPES registry on March 14, 2018.

Where is Deaconess Clinic, Inc located?

Deaconess Clinic, Inc is located at 930 W Main St, Boonville, IN 47601. The listed phone number is (812) 641-0088.

What is Deaconess Clinic, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Deaconess Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2144696) is associated with this NPI, valid through February 20, 2028. 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 March 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.