DEACONESS MEMORIAL MEDICAL CENTER INC
NPI 1174603153
Family Medicine in Dale, IN
About Deaconess Memorial Medical Center Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEACONESS MEMORIAL MEDICAL CENTER INC (NPI 1174603153), doing business as Dale Family Medicine, is a healthcare organization registered as a family medicine in Dale, Indiana and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through October 8, 2027 and lists Keith Miller, Cao & Indiana Region President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 2
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 Memorial Medical Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
171Medicare enrollment records show 171 clinicians reassign Medicare billing to Deaconess Memorial Medical Center Inc, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 26
Nearest to this location (20)
See all 171Source: 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 of Waiver 15D0988549
Deaconess Memorial Center Dale Family Medicine · Dale, INFrequently 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 Memorial Medical Center Inc's NPI number?
The NPI number for Deaconess Memorial Medical Center Inc is 1174603153. It was assigned to this organization in the NPPES registry on October 16, 2006. The provider is doing business as Dale Family Medicine.
Where is Deaconess Memorial Medical Center Inc located?
Deaconess Memorial Medical Center Inc is located at 4 W Vine St, Dale, IN 47523. The listed phone number is (812) 937-7140.
What is Deaconess Memorial Medical Center Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Deaconess Memorial Medical Center Inc enrolled in Medicare?
Yes. Deaconess Memorial Medical Center Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Deaconess Memorial Medical Center Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 171 clinicians in 26 Medicare specialties reassign their Medicare billing to Deaconess Memorial Medical Center 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 (53), Family Practice (20) and Emergency Medicine (16). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Deaconess Memorial Medical Center Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D0988549) is associated with this NPI, valid through October 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Deaconess Memorial Medical Center Inc accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Deaconess Memorial Medical Center 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 Memorial Medical Center Inc was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 Memorial Medical Center Inc · NPI 1174603153
Family Medicine organization in Dale, Indiana. Organization record, active in the CMS NPPES registry since October 16, 2006.
## Identity
- **NPI:** 1174603153 (Entity type: Organization)
- **Enumerated:** October 16, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Dale Family Medicine (Doing Business As)
- **Organization subpart:** Yes (part of Deaconess Memorial Medical Center Inc)
- **Authorized official:** Keith Miller, CAO & INDIANA REGION PRESIDENT
## Practice location
- **Address:** 4 W VINE ST, Dale, IN 47523
- **Phone:** (812) 937-7140 · **Fax:** (812) 937-7145
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 171 clinicians in 26 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (53), Family Practice (20), Emergency Medicine (16); 8 practice within 10 miles; [full list](https://npiprofile.com/npi/1174603153/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 16, 2026
- **Other identifiers:** Other CB3118 (KY); Medicaid 200282080A (IN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174603153) · Data from the CMS NPPES public registry.