Individual provider Active NPI

Derrick Peter Yoder, D.C.

  • Chiropractor
  • Indianapolis, IN
National Provider Identifier
1053597971
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002374A Issued in IN
Practice address
7855 S Emerson Ave
Ste Q
Indianapolis, IN 46237-8669
Phone
(317) 884-2636
NPI assigned
Jan 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002374A IN Primary

Addresses

Primary practice location

7855 S Emerson Ave
Ste Q
Indianapolis, IN 46237-8669

Mailing address

7855 S Emerson Ave
Ste Q
Indianapolis, IN 46237-8669
Phone (317) 884-2636

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002374AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cerefin Chiropractic Clinic, Inc. Chiropractor CurrentSince Mar 22, 2022 Accepting new patients

Locations

7855 S Emerson Ave
Ste Q
Indianapolis, IN 46237
Phone (317) 884-2636

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1053597971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 S EMERSON AVE",
            "address_2": "STE Q",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378669",
            "telephone_number": "317-884-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 S EMERSON AVE",
            "address_2": "STE Q",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378669",
            "telephone_number": "317-884-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "DERRICK",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002374A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.