Keith Andrew Derco, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101052086 Issued in VA

Practice address

11551 Nuckols Rd
Suite F
Glen Allen, VA 23059-5565

Phone

(804) 364-4400

Fax

(804) 364-0120

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1255424206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD",
            "address_2": "SUITE F",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-364-4400",
            "fax_number": "804-364-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD",
            "address_2": "SUITE F",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-364-4400",
            "fax_number": "804-364-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERCO",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101052086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Dellaripa, RN, FNP-BC
• Stephen M Delo Jr., LCSW
• Delta Medical Transport, Inc.
• Dental Professionals of Virginia, P.C.
• Ronald James Depue Jr., RPH
• Neemisha Desai, DC
• Bethann Wise Detwiler, M.A., L.P.C.
• Devine Physical Therapy and Wellness
• Andrea Devooght
• Thomas Merrill Dewire Sr., M.D.

• Pediatrics Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.