Jed E. Derrickson, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09463 Issued in MD

Practice address

505 E Main St
Q
Salisbury, MD 21804-5020

Phone

(410) 742-8882

NPI assigned

Oct 4, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

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.

• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment Care Compare group NPD
• Cove Recovery, LLC

  • Mental Health Counselor
  • Salisbury, MD
  • NPI 1013241611

  Clinical

  Medicare reassignment NPD
• Cove Recovery, LLC

  • Mental Health Counselor
  • Cambridge, MD
  • NPI 1417338153
  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD
• Christiana Care Health Services Inc

  • Infectious Disease Physician
  • Wilmington, DE
  • NPI 1326022476
  NPD (past)
• Christiana Care Health Services, Inc

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1003850504
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1164518668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2, BOX 155A",
            "city": "DAGSBORO",
            "state": "DE",
            "postal_code": "19939",
            "telephone_number": "302-539-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "address_2": "Q",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-742-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICKSON",
        "first_name": "JED",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09463",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q10000744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298470900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Susan Dennis, FNP
• Jennifer Denteh, PHARM D
• Adam M Deporter, PA-C
• Andrea Denston Deprima, LCSW-C
• Victoria Paige Derosa, LMSW
• Brian M Desaulniers, MD
• Aushae Deshields
• Rene L Desmarais, M.D.
• Jane Marie Devine, CRNP
• Kathleen A Devine, MD

• Clinical Social Worker in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.