Bobby Lee Derrick, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

019510 Issued in GA

Practice address

117 Kite Rd
Swainsboro, GA 30401-3231

Phone

(478) 289-1368

Fax

(478) 289-1300

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

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  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124100359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304010879",
            "telephone_number": "478-289-1368",
            "fax_number": "478-289-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KITE RD",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013231",
            "telephone_number": "478-289-1368",
            "fax_number": "478-289-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "BOBBY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "019510",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "019510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Crooke, LPC
• Crossroads Wellness PC
• Lydia Lee Daley, PMHNP, BC
• Suffearria Makia Daniels-Ellison, NURSE PRACTITIONER
• Debbie Jean Davis, RN
• Vinh Dong, MD
• Paul Andrew Dorsett, MMS, PA-C
• Dr. WM. Allen Herren,LLC
• Katie Durden, PMHNP-BC
• Berine Denise Early

• Emergency Medicine Physician in Swainsboro, GA
• Providers in Swainsboro, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.