Taylor Lynn Derrico, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00457 Issued in MS

Practice address

501 Marshall St Ste 104
Jackson, MS 39202-1663

Phone

(601) 969-6404

Fax

(601) 973-4541

NPI assigned

Jul 20, 2017

Last updated

Nov 13, 2025By the provider in NPPES

Sex

Female

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 MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation of Central Mississippi IncGroup PAC ID 1153216411, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Merit-based Incentive Payment System (MIPS)

Final score

78.38 of 100Reported as group

Quality

54.22

Promoting interoperability

100

Improvement activities

40

Cost

73.72

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tfrering149421@ummc.direct-ci.com
• Direct secure messaging: tfrering472420@direct.bmhcc.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Foundation of Central Mississippi, Inc.

  dba Baptist Medical Clinics

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment Care Compare group NPD
• Mississippi Baptist Medical Center, Inc.

  dba MBMC - Neuro Hospitalists

  • Neurology Physician
  • Jackson, MS
  • NPI 1467589556
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Baptist Medical Clinic - Convenient Care

  • Multi-Specialty Clinic/Center
  • Flowood, MS
  • NPI 1013207091
  NPD
• Medical Foundation of Central Ms

  dba Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• State of Mississippi - University of Mississippi Medical Center

  dba UMMC Greenwood Women's Clinic

  • Rural Health Clinic/Center
  • Greenwood, MS
  • NPI 1225800428
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1164945218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 104",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021663",
            "telephone_number": "601-969-6404",
            "fax_number": "601-973-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICO",
        "first_name": "TAYLOR",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00457",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MS",
            "license": "PA00457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattie Derivaux
• Dermatology Associates LLC
• Dermatopathology Associates, PLLC
• Benjamin David Derrick, BIBLICAL COUNSELOR
• Jessica Derrick, FNP-C
• Jagdish Desai, M.D.
• Shivum Kumar Desai
• Smruti Pranav Desai, MD
• Richard D Deshazo, MD
• Lisa Marie Desselles, LCSW

• Surgical Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Surgical Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.