Active NPI
Matthew Thomas Derry, D.C.
- Chiropractor
- Parker, CO
National Provider Identifier
1124294921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHR-6229
- Practice address
- 12919 Stroh Ranch CT
Unit B
Parker, CO 80134-7707 - Phone
- (720) 851-2475
- Fax
- (720) 851-2476
- NPI assigned
- May 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR-6229 | CO | Primary |
Addresses
Primary practice location
12919 Stroh Ranch CT
Unit B
Parker, CO 80134-7707
Mailing address
12919 Stroh Ranch CT
Unit B
Parker, CO 80134-7707
Phone (720) 851-2475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18551 E Mainstreet
Suite 1D
Parker, CO 80134-4951
Phone (720) 851-7400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHR-6229 | CO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to Wellness | Chiropractor | Current | Accepting new patients |
Locations
12919 Stroh Ranch Ct
Unit B
Parker, CO 80134
Phone (720) 851-2475
18551 E Mainstreet
Ste 1D
Parker, CO 80134
Phone (720) 851-2475
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1124294921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12919 STROH RANCH CT",
"address_2": "UNIT B",
"city": "PARKER",
"state": "CO",
"postal_code": "801347707",
"telephone_number": "720-851-2475",
"fax_number": "720-851-2476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12919 STROH RANCH CT",
"address_2": "UNIT B",
"city": "PARKER",
"state": "CO",
"postal_code": "801347707",
"telephone_number": "720-851-2475",
"fax_number": "720-851-2476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERRY",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-01",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "CHR-6229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.