Individual provider Active NPI

Derek M Childers, MD

  • Internal Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1225659014
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-16670 Issued in AR
Practice address
300 Carson St
Jonesboro, AR 72401-3104
Phone
(870) 910-7799
NPI assigned
May 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-16670 AR Primary
Hospitalist Physician 208M00000X E-16670 AR

Addresses

Primary practice location

300 Carson St
Jonesboro, AR 72401-3104

Mailing address

300 Carson St
Jonesboro, AR 72401-3104
Phone (870) 910-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230829002702 AR Practitioner - Internal Medicine 5092178723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springdale Bentonville HBP Services LLCGroup PAC ID 1052759263, 88 clinicians

Practice addresses (Care Compare)

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

Hospital & facility affiliations

  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
  • Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-16670ARMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ies HSP Arkansas PLLC Hospitalist CurrentSince Aug 1, 2023 Accepting new patients
Springdale- Bentonville HBP Services, LLC Hospitalist CurrentSince Apr 29, 2024 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Siloam Springs Arkansas Hospital Company LLC Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

Interoperability endpoints

  • Direct secure messaging: derekchilders@sbpc.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1225659014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-910-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-910-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "DEREK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-03",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-16670",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-16670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.