Derek Varney, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA051903 Issued in PA

Practice address

735 Norman Dr # DR3
Lebanon, PA 17042-7559

Phone

(717) 270-7908

Fax

(717) 272-1734

NPI assigned

Apr 19, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1144510538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S JACKSON ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013625",
            "telephone_number": "570-621-5000",
            "fax_number": "570-621-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 NORMAN DR # DR3",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427559",
            "telephone_number": "717-270-7908",
            "fax_number": "717-272-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNEY",
        "first_name": "DEREK",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004216",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "MA051903",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Cory Vanderbrook, CTRS
• Venkatarami Reddy Vangala, M.D
• Admary Vargas
• Mansey Varghese, MD
• Ellen Alyce Varner, MSW, LCSW
• Jessica Elizabeth Varney, DPT
• Ashley Elizabeth Vasile, RN
• Melinda Vates, LCSW
• Christopher Wayne Vaughn, DO
• Emily Velez

• Physician Assistant in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.