Active NPI
Derrick Roberts Nutter
- Student in an Organized Health Care Education/Training Program
- Standish, ME
National Provider Identifier
1023925294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 278 Whites Bridge Rd Ste 1
Standish, ME 04084-5263 - Phone
- (207) 892-6766
- NPI assigned
- Aug 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | ME | Primary |
Addresses
Primary practice location
278 Whites Bridge Rd Ste 1
Standish, ME 04084-5263
Mailing address
14 Bea St
Dover Foxcroft, ME 04426-3616
Phone (207) 717-9584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1023925294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 BEA ST",
"city": "DOVER FOXCROFT",
"state": "ME",
"postal_code": "044263616",
"telephone_number": "207-717-9584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 WHITES BRIDGE RD STE 1",
"city": "STANDISH",
"state": "ME",
"postal_code": "040845263",
"telephone_number": "207-892-6766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTTER",
"first_name": "DERRICK",
"middle_name": "ROBERTS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "ME",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Standish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.