Individual provider Active NPI

Derry Dean Dye Jr., MD

  • Pediatrics Physician
  • Poplar Bluff, MO
National Provider Identifier
1215949599
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R5G11 Issued in MO
Practice address
225 Physicians Park Ste 200
Poplar Bluff, MO 63901-3921
Phone
(573) 727-5500
Fax
(573) 313-3684
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R5G11 MO Primary

Addresses

Primary practice location

225 Physicians Park Ste 200
Poplar Bluff, MO 63901-3921

Mailing address

110 S 2ND St
Ellington, MO 63638-9400
Phone (573) 663-2313

Other practice location 1

1 Hals Plz Ste A
Piedmont, MO 63957-1631
Phone (573) 223-4800

Other practice location 2

17959 Main St
Eminence, MO 65466-6375
Phone (573) 226-5505

Other practice location 3

18 Viburnum Center Rd
Viburnum, MO 65566-7802
Phone (573) 244-5406

Other practice location 4

603 E Summit St
Doniphan, MO 63935-1142
Phone (573) 996-3667 ext. 1117

Other practice location 5

109 Plum St Ste C
Doniphan, MO 63935-1225
Phone (573) 351-0150

Other practice location 6

109 LeRoux St
Doniphan, MO 63935-1038
Phone (573) 996-2136

Other practice location 7

3277 US Highway 160 W
Doniphan, MO 63935-5710
Phone (573) 804-9527

Other practice location 8

289 Broadway St
Neelyville, MO 63954-7176
Phone (573) 804-9494

Other practice location 9

225 Physicians Park Ste 104
Poplar Bluff, MO 63901-3918
Phone (573) 413-4065

Other practice location 10

405 Main Street
Van Buren, MO 63965
Phone (573) 323-4253

Other practice location 11

1300 Victory Ln
Poplar Bluff, MO 63901-3300
Phone (573) 785-5566 ext. 17097

Other practice location 12

101 E Batten Street
Naylor, MO 63953
Phone (573) 804-1779

Other practice location 13

202 Allen St
Annapolis, MO 63620-8778
Phone (573) 598-4213

Other practice location 14

61 Highway Y
Ellington, MO 63638-7802
Phone (573) 663-2525

Other practice location 15

109 Plum St Ste A
Doniphan, MO 63935-1225
Phone (573) 351-0150

Other practice location 16

315 W Mulberry Ste A
Pilot Knob, MO 63663-7883
Phone (573) 546-0602

Other practice location 17

711 Nickey St
Poplar Bluff, MO 63901-6544
Phone (573) 785-7047 ext. 13040

Other practice location 18

11001 US-160
Harviell, MO 63945
Phone (573) 804-9561

Other practice location 19

3001 Warrior Ln Ste A
Poplar Bluff, MO 63901-8685
Phone (573) 785-7453

Other practice location 20

2210 Barron Rd Ste 120
Poplar Bluff, MO 63901-1922
Phone (573) 785-6536

Other practice location 21

109 Plum St Ste B
Doniphan, MO 63935-1225
Phone (573) 351-0220

Other practice location 22

225 Physicians Park Ste 304
Poplar Bluff, MO 63901-3930
Phone (573) 727-5500 ext. 6

Other practice location 23

2300 Baugh Ln
Poplar Bluff, MO 63901-2402
Phone (573) 785-3037 ext. 16044

Other practice location 24

225 Physicians Park Ste 102
Poplar Bluff, MO 63901-3918
Phone (573) 727-5500 ext. 2

Other practice location 25

220 East Broad Street
Naylor, MO 63953
Phone (573) 399-2311

Other practice location 26

2879 James Blvd
Poplar Bluff, MO 63901-3395
Phone (573) 712-1610

Other practice location 27

2879 James Blvd
Poplar Bluff, MO 63901-3395
Phone (573) 609-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829000171 MO Practitioner - Pediatric Medicine 6002726940 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Jul 21, 2019 Accepting new patients
Big Springs Medical Association CurrentSince Feb 2, 2026 Accepting new patients
Saint Francis Medical Center Pediatrics CurrentSince Jul 21, 2019 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Big Springs Medical Association CurrentSince Feb 2, 2026 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

110 S 2nd St
Ellington, MO 63638
Phone (573) 663-2316

225 Physicians Park
Ste 200
Poplar Bluff, MO 63901
Phone (573) 727-9995

2210 Barron Rd
Ste 120
Poplar Bluff, MO 63901
Phone (573) 785-2005

225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721

Interoperability endpoints

  • Direct secure messaging: ddye93726@surescripts.sfmc.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1215949599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 2ND ST",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636389400",
            "telephone_number": "573-663-2313",
            "fax_number": "573-663-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 200",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013921",
            "telephone_number": "573-727-5500",
            "fax_number": "573-313-3684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hals Plz Ste A",
            "address_purpose": "LOCATION",
            "city": "Piedmont",
            "state": "MO",
            "postal_code": "639571631",
            "country_code": "US",
            "telephone_number": "573-223-4800",
            "fax_number": "573-223-7911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17959 Main St",
            "address_purpose": "LOCATION",
            "city": "Eminence",
            "state": "MO",
            "postal_code": "654666375",
            "country_code": "US",
            "telephone_number": "573-226-5505",
            "fax_number": "573-226-1256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Viburnum Center Rd",
            "address_purpose": "LOCATION",
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            "state": "MO",
            "postal_code": "655667802",
            "country_code": "US",
            "telephone_number": "573-244-5406",
            "fax_number": "573-244-5591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 E Summit St",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351142",
            "country_code": "US",
            "telephone_number": "573-996-3667 x1117",
            "fax_number": "573-413-4487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste C",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-0150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 LeRoux St",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351038",
            "country_code": "US",
            "telephone_number": "573-996-2136",
            "fax_number": "573-996-5216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3277 US Highway 160 W",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639355710",
            "country_code": "US",
            "telephone_number": "573-804-9527",
            "fax_number": "573-804-9536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "289 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Neelyville",
            "state": "MO",
            "postal_code": "639547176",
            "country_code": "US",
            "telephone_number": "573-804-9494",
            "fax_number": "573-804-9493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 104",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013918",
            "country_code": "US",
            "telephone_number": "573-413-4065",
            "fax_number": "573-354-5013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Main Street",
            "address_purpose": "LOCATION",
            "city": "Van Buren",
            "state": "MO",
            "postal_code": "63965",
            "country_code": "US",
            "telephone_number": "573-323-4253",
            "fax_number": "573-323-0154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Victory Ln",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013300",
            "country_code": "US",
            "telephone_number": "573-785-5566 x17097",
            "fax_number": "573-413-4194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E Batten Street",
            "address_purpose": "LOCATION",
            "city": "Naylor",
            "state": "MO",
            "postal_code": "63953",
            "country_code": "US",
            "telephone_number": "573-804-1779",
            "fax_number": "573-804-1789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Allen St",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MO",
            "postal_code": "636208778",
            "country_code": "US",
            "telephone_number": "573-598-4213",
            "fax_number": "573-598-1101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 Highway Y",
            "address_purpose": "LOCATION",
            "city": "Ellington",
            "state": "MO",
            "postal_code": "636387802",
            "country_code": "US",
            "telephone_number": "573-663-2525",
            "fax_number": "573-663-7844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste A",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-0150",
            "fax_number": "573-996-2245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 W Mulberry Ste A",
            "address_purpose": "LOCATION",
            "city": "Pilot Knob",
            "state": "MO",
            "postal_code": "636637883",
            "country_code": "US",
            "telephone_number": "573-546-0602",
            "fax_number": "573-546-0546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 Nickey St",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639016544",
            "country_code": "US",
            "telephone_number": "573-785-7047 x13040",
            "fax_number": "573-413-4192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11001 US-160",
            "address_purpose": "LOCATION",
            "city": "Harviell",
            "state": "MO",
            "postal_code": "63945",
            "country_code": "US",
            "telephone_number": "573-804-9561",
            "fax_number": "573-804-9581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3001 Warrior Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639018685",
            "country_code": "US",
            "telephone_number": "573-785-7453",
            "fax_number": "573-785-7429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2210 Barron Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639011922",
            "country_code": "US",
            "telephone_number": "573-785-6536",
            "fax_number": "573-785-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste B",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-0220",
            "fax_number": "573-996-2246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 304",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013930",
            "country_code": "US",
            "telephone_number": "573-727-5500 x6",
            "fax_number": "573-399-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Baugh Ln",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639012402",
            "country_code": "US",
            "telephone_number": "573-785-3037 x16044",
            "fax_number": "573-413-4506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Physicians Park Ste 102",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013918",
            "country_code": "US",
            "telephone_number": "573-727-5500 x2",
            "fax_number": "573-413-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 East Broad Street",
            "address_purpose": "LOCATION",
            "city": "Naylor",
            "state": "MO",
            "postal_code": "63953",
            "country_code": "US",
            "telephone_number": "573-399-2311",
            "fax_number": "573-399-2076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2879 James Blvd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013395",
            "country_code": "US",
            "telephone_number": "573-712-1610",
            "fax_number": "573-776-6124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2879 James Blvd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639013395",
            "country_code": "US",
            "telephone_number": "573-609-8800",
            "fax_number": "573-776-6124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYE",
        "first_name": "DERRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R5G11",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.