Derek Maynard, SRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3017779 Issued in KY

Practice address

2106 Shadyside Rd Apt D
Saint Albans, WV 25177-3465

Phone

(304) 687-5771

NPI assigned

Mar 31, 2022

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

Enrolled in KY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Anesthesia, PSCGroup PAC ID 5092627521, 181 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Commonwealth Anesthesia, PSC

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1437196300

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Associates, PSC

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1902991169

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Health System Inc

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1215227012

  Hospital

  Care Compare affiliation
• Saint Joseph Health System, Inc

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1437150984
  Care Compare affiliation
• Saint Joseph Health System, Inc

  • Clinic/Center
  • Nicholasville, KY
  • NPI 1861650814

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1134869589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ANGUS E PEYTON DR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 SHADYSIDE RD APT D",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251773465",
            "telephone_number": "304-687-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "DEREK",
        "credential": "SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3017779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mareda L. Reynolds Ma PLLC
• Mallory Rei Marsico, PRSS
• Rebecca Martin
• Michael F Maruish
• De'Ana Lindsey May
• Heather McClanahan
• Sonja Maria McClung
• Haley McCormick
• Kirsten McCoy
• Pernell McCoy, LPC,CADC,MAC

• Certified Registered Nurse Anesthetist in Saint Albans, WV
• Providers in Saint Albans, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.

Verify at the official NPI Registry.