Rebecca D Derby, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

20361 Issued in TN

Practice address

980 Professional Park Dr
Ste. C
Clarksville, TN 37040-5251

Phone

(931) 647-5747

NPI assigned

Sep 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fep of Kentucky LLCGroup PAC ID 8123473626, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Fep of Kentucky LLC

  • Emergency Medicine Physician
  • Hopkinsville, KY
  • NPI 1770266553

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236

  Nurse Practitioner

  Medicare reassignment NPD
• Havely Springs Emergency Group, PC

  • Emergency Medicine Physician
  • Springfield, TN
  • NPI 1770090110

  Nurse Practitioner

  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  Nurse Practitioner, TN

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clarksville Health System, LLC

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794
  Care Compare affiliation

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1053789149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681789",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 PROFESSIONAL PARK DR",
            "address_2": "STE. C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405251",
            "telephone_number": "931-647-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "REBECCA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "20361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016334",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Tittle Dba Best Care Clinic
• Abegaile Santiago Denison, M.D.
• Aubrea Dennen, LMFT
• Toi Neshae Dennis, PHD
• Dental Sleep Solutions of Clarksville LLC
• Alexis Michelle Dermady
• Grace Daylee Derricks-Horne
• Herat Vidyut Desai, PT
• Ashton B Deshotel
• Kaelyn Desmarais

• Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.