Michael Ian Derrick, M.D.

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

MD65969 Issued in TN

Practice address

1272 Garrison Dr
Murfreesboro, TN 37129-2598

Phone

(615) 893-4480

Fax

(615) 895-6212

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Allergy/Immunology

Education

Vanderbilt University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Murfreesboro Medical Clinic, P.a.Group PAC ID 4789589227, 176 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.82 of 100Reported as apm

Quality

79.78

Promoting interoperability

93.11

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelderrick@mmcsc.allscriptsdirect.net

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.

• Murfreesboro Medical Clinic, P.a.

  • Specialist
  • Murfreesboro, TN
  • NPI 1487604609
  Medicare reassignment Care Compare group
• Murfreesboro Medical Clinic, P.a.

  • Specialist
  • Murfreesboro, TN
  • NPI 1639299803
  NPD

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1275828717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480",
            "fax_number": "615-895-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480",
            "fax_number": "615-895-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "MICHAEL",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "KS",
            "license": "04-40205",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MO",
            "license": "2017023519",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "TN",
            "license": "MD65969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veteran Affairs
• Depriest Center
• Shannon Marie Depriest, MSN, FNP-BC
• Dept. of Veterans Affairs
• Briahna Derr, ATC
• Robert Desalvo
• Desert Rose Dental, PLLC
• Chloe L. Desnoes
• Jennifer Lynn Devan, PH.D.
• Jude Dewald

• Pediatric Allergy/Immunology Physician in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Pediatric Allergy/Immunology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.