Individual provider Active NPI

Derick Ngu

  • Psychiatric/Mental Health Nurse Practitioner
  • Cottage Grove, MN
National Provider Identifier
1225945496
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14676 Issued in MN
Practice address
6022 Inman Alcove S
Cottage Grove, MN 55016-3572
Phone
(651) 208-4950
NPI assigned
Aug 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14676 MN Primary

Addresses

Primary practice location

6022 Inman Alcove S
Cottage Grove, MN 55016-3572

Mailing address

6022 Inman Alcove S
Cottage Grove, MN 55016-3572
Phone (651) 208-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1225945496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6022 INMAN ALCOVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163572",
            "telephone_number": "651-208-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6022 INMAN ALCOVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163572",
            "telephone_number": "651-208-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGU",
        "first_name": "DERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "14676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.