| Evansville Primary Care | |
|
4933 E Plaza East Blvd Evansville IN 47715-2813 | |
| (812) 479-6907 | |
| (812) 479-6967 |
| Full Name | Evansville Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 4933 E Plaza East Blvd, Evansville, Indiana |
| Authorized Official Name and Position | Kaylynn Cantacessi (MANAGER) |
| Authorized Official Contact | 8124796907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evansville Primary Care 4933 E Plaza East Blvd Evansville IN 47715-2813 Ph: (812) 401-8720 | Evansville Primary Care 4933 E Plaza East Blvd Evansville IN 47715-2813 Ph: (812) 479-6907 |
| NPI Number | 1629027800 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 08/01/2023 |
| Medicare PECOS PAC ID | 7416965199 |
|---|---|
| Medicare Enrollment ID | O20060323000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629027800 | NPI | - | NPPES |
| 200321590 | Medicaid | IN | |
| 1912987363 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | David E Brougher |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1740260199 PECOS PAC ID: 2860599347 Enrollment ID: I20070517000304 |
| Provider Name | David Earl Schultz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912987363 PECOS PAC ID: 0345309258 Enrollment ID: I20081107000017 |
| Provider Name | Lindsey R Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962831412 PECOS PAC ID: 2163650185 Enrollment ID: I20140118000371 |
| Provider Name | Stacey L Ricketts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871053363 PECOS PAC ID: 5991046211 Enrollment ID: I20190412001737 |
| Provider Name | Brittney Phipps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548830821 PECOS PAC ID: 4587068481 Enrollment ID: I20210813000576 |
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