Active NPI
Jessica Spears Derusha, RDH
- Dental Hygienist
- Gallatin, TN
National Provider Identifier
1265319735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6161
- Practice address
- 615 Commons Dr
Gallatin, TN 37066-6318 - Phone
- (615) 230-6611
- Fax
- (615) 230-6614
- NPI assigned
- Aug 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6161 | TN | Primary |
Addresses
Primary practice location
615 Commons Dr
Gallatin, TN 37066-6318
Mailing address
200 Carellton Dr
Gallatin, TN 37066-1426
Phone (615) 406-7372
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6161 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1265319735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CARELLTON DR",
"city": "GALLATIN",
"state": "TN",
"postal_code": "370661426",
"telephone_number": "615-406-7372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 COMMONS DR",
"city": "GALLATIN",
"state": "TN",
"postal_code": "370666318",
"telephone_number": "615-230-6611",
"fax_number": "615-230-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUSHA",
"first_name": "JESSICA",
"middle_name": "SPEARS",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-18",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TN",
"license": "6161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallatin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.