Derrick Gilbert, CRADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1364 Issued in MO

Practice address

895 State Highway 248 Ste C
Branson, MO 65616-4013

Phone

(417) 544-8394

NPI assigned

Oct 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Derrick Gilbert Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1093312811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CASTLE LN",
            "city": "HIGHLANDVILLE",
            "state": "MO",
            "postal_code": "656698096",
            "telephone_number": "417-838-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 STATE HIGHWAY 248 STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656164013",
            "telephone_number": "417-544-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "DERRICK",
        "credential": "CRADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "1364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DERRICK",
            "last_name": "GILBERT",
            "credential": "CRADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Branson, MO
• Providers in Branson, MO by specialty
• Addiction (Substance Use Disorder) Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.