Derick E. Vergne, MD PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

DERICK E. VERGNE, MD PLLC

Practice address

179 Great Rd Ste 201
Acton, MA 01720-5774

Phone

(857) 239-1911

Fax

(617) 544-0937

NPI assigned

Sep 1, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Derick Vergne, MDNPI 1013066083

Title

Owner/Provider

Phone

(857) 239-1911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derick E Vergne, MD

  • Psychiatry Physician
  • Acton, MA
  • NPI 1013066083
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1003536798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 GREAT RD",
            "address_2": "STE 201",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "01720",
            "telephone_number": "857-239-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 GREAT RD STE 201",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205774",
            "telephone_number": "857-239-1911",
            "fax_number": "617-544-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERICK E. VERGNE, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "VERGNE",
        "authorized_official_first_name": "DERICK",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "857-239-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josette Deceus
• Lea S Decoteau, MSPT
• Jill Marie Defoe, LICSW
• Peter James Demartino, M.D.
• Derick E. Vergne MD, PLLC
• Raj Devarajan, MD
• Devita Chiropractic LLC
• Renee E Deyoe, MSW LICSW
• Barry Diamond, D.C.
• Deborah Diamond, D.C.

• Psychiatry Physician in Acton, MA
• Providers in Acton, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.