Mitchell Eugene Derrick, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0003132 Issued in WA

Practice address

3535 Martin Way E.
Olympia, WA 98506

Phone

(360) 438-6425

Fax

(360) 923-9382

NPI assigned

Oct 4, 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derrick Family Chiropractic, Inc.Group PAC ID 3577695683, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Derrick Family Chiropractic, Inc.

  • Chiropractor
  • Olympia, WA
  • NPI 1891014411
  Medicare reassignment Care Compare group Authorized official
• Sweet Chiropractic Inc PS

  • Clinic/Center
  • Olympia, WA
  • NPI 1811291065
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1265527154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARTIN WAY E.",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-438-6425",
            "fax_number": "360-923-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARTIN WAY E.",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-438-6425",
            "fax_number": "360-923-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "MITCHELL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH0003132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPART. OF LI",
            "identifier": "101194/164269",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE/BLUE SHIELD",
            "identifier": "DE3088",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022028",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA/BLUE CROSS",
            "identifier": "91-2132905",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frauke Christa Depetter, LMT
• Gary Depriest, PA-C
• Derma PLLC (Derma Medical Spa)
• Dermatology & Allergy Specialists
• Derrick Family Chiropractic, Inc.
• Laurie E Deschenes
• Sarah Rubin Destasio
• Madelyn Joan Dethlefs
• Nicodemus Deu Sr.
• Jane Michele Deusen, LPN

• Chiropractor in Olympia, WA
• Providers in Olympia, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.