Haskell Ray Derryberry, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

582138 Issued in TX

Practice address

1322 Paluxy Rd
Suite #2
Granbury, TX 76048-5603

Phone

(817) 579-1642

Fax

(817) 579-9926

NPI assigned

Jun 8, 2006

Last updated

Jun 19, 2008By the provider in NPPES

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 TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment NPD
• CLH Physicians PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1073613931
  NPD (past)
• Emcare-Dtxemergency Physicians PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1285709600
  NPD (past)
• Harold Wagner DO PA

  dba Home Care Physicians

  • Geriatric Medicine (Family Medicine) Physician
  • Dallas, TX
  • NPI 1255438701
  NPD (past)
• Hood Medical Group

  • Family Medicine Physician
  • Granbury, TX
  • NPI 1225096472
  NPD (past)
• Indelible Health & Wellness LLC

  dba Texas Visiting Doctors

  • Family Medicine Physician
  • Grand Prairie, TX
  • NPI 1245569946
  NPD (past)
• Motley Emergency Physicians

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1972558401
  NPD (past)
• Texas Em-1 Medical Services PA

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1659446193
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Physician Assistant
  • Mesquite, TX
  • NPI 1295780757
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1942253083
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1093755704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 PALUXY RD",
            "address_2": "SUITE 2",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485603",
            "telephone_number": "817-579-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 PALUXY RD",
            "address_2": "SUITE #2",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485603",
            "telephone_number": "817-579-1642",
            "fax_number": "817-579-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRYBERRY",
        "first_name": "HASKELL",
        "middle_name": "RAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "582138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Delaney
• Delia I. Wright, MD, PA
• Susan M Denevan, LCDC
• Dental Professionals of Texas, P.a. (Granbury Dental Center)
• Depot Bay,Inc (Nucardio-Heart-Center)
• Avi Deshmukh, M.D.
• Beth Deskin
• Elizabeth Dever
• Marcie Diamond, PTA
• DME Solutions LP

• Family Nurse Practitioner in Granbury, TX
• Providers in Granbury, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.