Individual provider Active NPI

Derrick Stephens

  • Other Technician
  • Americus, GA
National Provider Identifier
1134040082
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
103 Knollwood Dr
Americus, GA 31709-5334
Phone
(229) 591-4000
NPI assigned
Jul 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

103 Knollwood Dr
Americus, GA 31709-5334

Mailing address

122 W Forsyth St
Americus, GA 31709-3561
Phone (229) 591-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1134040082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W FORSYTH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093561",
            "telephone_number": "229-591-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 KNOLLWOOD DR",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317095334",
            "telephone_number": "229-591-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DERRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.