Jeffrey James Derr, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

55049 Issued in MN

Practice address

1900 Centracare Cir Ste 1575
St. Cloud Hospital/Plaza Rehabilitation
St Cloud, MN 56303-5000

Phone

(320) 229-4944

Fax

(320) 229-5156

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jderr33786@direct.centracare.com

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1063402402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1575",
            "address_2": "ST. CLOUD HOSPITAL/PLAZA REHABILITATION",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4944",
            "fax_number": "320-229-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1575",
            "address_2": "ST. CLOUD HOSPITAL/PLAZA REHABILITATION",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4944",
            "fax_number": "320-229-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERR",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "55049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Depa, RN
• Brent D Deragisch, DDS
• Holly Annette Derifield, LPN
• Dermatology Professionals PA
• Fahin Mohamed Derow
• Eduardo Pasion Desanto, M.D.
• Kylie Danielle Deschane
• Anne Elizabeth Deters, RN
• Anne Elizabeth Deters, LPCC
• Jenifer Karen Detert, P.A.

• Physical Medicine & Rehabilitation Physician in St Cloud, MN
• Providers in St Cloud, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.