Individual provider Active NPI

Derrick Degraff

  • Behavior Technician
  • Augusta, GA
National Provider Identifier
1043001720
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4106 Columbia Rd
Augusta, GA 30907-1450
Phone
(706) 426-0583
NPI assigned
May 13, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TB0200X
Behavior Technician 106S00000X GA Primary

Addresses

Primary practice location

4106 Columbia Rd
Augusta, GA 30907-1450

Mailing address

701 Spalding CT
Martinez, GA 30907-2970
Phone (862) 216-1886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1043001720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SPALDING CT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072970",
            "telephone_number": "862-216-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 COLUMBIA RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309071450",
            "telephone_number": "706-426-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAFF",
        "first_name": "DERRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.