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DEACONESS SPECIALITY PHYSICIANS, INC
NPI 1306418405
Internal Medicine - Nephrology in Henderson, KY

Active since July 16, 2021CLIA 15D2313460 · Waiver
340 STARLITE DR, HENDERSON, KY 42420(812) 492-5202(812) 450-8102 Get Directions Write a Review

NPPES record last updated: July 16, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Deaconess Speciality Physicians, Inc NPPES

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

DEACONESS SPECIALITY PHYSICIANS, INC (NPI 1306418405) is a healthcare organization registered as a nephrology in Henderson, Kentucky and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Cheryl Annette Wathen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1306418405
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameDEACONESS SPECIALITY PHYSICIANS, INC
Location Address340 STARLITE DRHenderson, KY 42420-6102
Mailing AddressPo Box 1230Evansville, IN 47706-1230
Phone(812) 492-5202
Fax(812) 450-8102
Organization SubpartNo
Authorized OfficialCheryl Annette WathenCfo · (812) 450-3296
Enumeration DateJuly 16, 2021
NPPES CertifiedJuly 16, 2021
✔ NPI 1306418405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
340 STARLITE DR, Henderson, KY 42420
Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 15D2313460

Deaconess Speciality Physicians, Inc/Ne Mob2 Gateway · Newburgh, IN
Active · expires Oct 30, 2026
CLIA Number15D2313460
Laboratory TypePhysician Office
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorNarothama R. Aeddula
Laboratory Phone(812) 492-5202
Laboratory LocationDeaconess Speciality Physicians, Inc/Ne Mob2 Gateway4209 Gateway Blvd, Suite 2100, Newburgh, IN 47630
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

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

MARIA C ALJABI M.D.
Pediatrics (Pediatric Gastroenterology)
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8027
DEACONESS CLINIC
Clinic/Center (Occupational Medicine)
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8515
KAREN R CANLAS MD
Internal Medicine (Gastroenterology)
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8027
DEACONESS CLINIC, INC
Internal Medicine
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8027
DEACONESS CLINIC, INC.
Family Medicine
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8515
DEACONESS CLINIC INC
Nurse Practitioner
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 215-3183
SARAH J FAXON APRN
Nurse Practitioner
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 215-3150
GERRI L MOORE ARNP
Nurse Practitioner
340 STARLITE DR
HENDERSON, KY 42420
Henderson County (270) 844-8515

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 Speciality Physicians, Inc's NPI number?

The NPI number for Deaconess Speciality Physicians, Inc is 1306418405. It was assigned to this organization in the NPPES registry on July 16, 2021.

Where is Deaconess Speciality Physicians, Inc located?

Deaconess Speciality Physicians, Inc is located at 340 Starlite Dr, Henderson, KY 42420. The listed phone number is (812) 492-5202.

What is Deaconess Speciality Physicians, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Deaconess Speciality Physicians, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2313460) is associated with this NPI, valid through October 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deaconess Speciality Physicians, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Deaconess Speciality Physicians, 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 Speciality Physicians, Inc was last updated on July 16, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.