Active NPI
Derek Miles Anderson, NURSE PRACTITIONER
- Nurse Practitioner
- Eastman, GA
National Provider Identifier
1326659798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP128292
- Practice address
- 1120 Indian Dr
Eastman, GA 31023-7670 - Phone
- (678) 858-8503
- NPI assigned
- Aug 11, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP128292 | GA | Primary |
Addresses
Primary practice location
1120 Indian Dr
Eastman, GA 31023-7670
Mailing address
505 Whittington Way
Peachtree City, GA 30269-3800
Phone (678) 858-8503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4837 Bill Gardner Pkwy
Suite B
Locust Grove, GA 30248-3644
Phone (678) 800-1602
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.62 of 100
- Quality
- 83.25
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP128292 | GA | MD | Nurse Practitioner |
Organizations & group practices 1
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.
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- Family Medicine Physician
- Hiram, GA
- NPI 1437194156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770163200000",
"number": "1326659798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 WHITTINGTON WAY",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302693800",
"telephone_number": "678-858-8503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 INDIAN DR",
"city": "EASTMAN",
"state": "GA",
"postal_code": "310237670",
"telephone_number": "678-858-8503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DEREK",
"middle_name": "MILES",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-11",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "NP128292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastman, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.