Derin Colvin

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10020433 Issued in OR

Practice address

1975 NW 167TH PL Ste 100-11
Beaverton, OR 97006-4908

Phone

(971) 571-5012

Fax

(971) 233-6448

NPI assigned

Jun 1, 2022

Last updated

Oct 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jagger & Crew International LLC

  dba Mission Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaverton, OR
  • NPI 1003659590
  NPD Authorized official
• Serenity TMS Centers LLC

  dba Serenity Mental Health Centers

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1710492095
  NPD

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1346989944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 SW BEAVERTON HILLSDALE HWY STE 250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL STE 100-11",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "971-571-5012",
            "fax_number": "971-233-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4545 E Chandler Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487646",
            "country_code": "US",
            "telephone_number": "480-626-7584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "DERIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "231751",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10020433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick Collins, LMT
• Seth Colner, D.C.
• Lise Colucci
• Columbia Care LLC (Right At Home)
• Hannah Colver
• Judith C. Colwell, PH.D.
• Wayne Ellsworth Colwell, PH.D.
• Rachel Ann Comingore, OTR/L
• Community Access Services II, Inc. (Community Access Services)
• Community Access Services II, Inc. (Community Access Services)

• Psychiatric/Mental Health Nurse Practitioner in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.