Active NPI
Derrick Monroe White, EMT-P
- Paramedic
- Ft Rucker, AL
National Provider Identifier
1356579098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Paramedic
- License
- P8009774
- Practice address
- Lyster Army Health Clinic
BLDG 301 Andrews Ave
Ft Rucker, AL 36362-5333 - Phone
- (334) 255-7032
- NPI assigned
- Jul 1, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | P8009774 | AL | Primary |
| Paramedic | 146L00000X | 0800998 | AL |
Addresses
Primary practice location
Lyster Army Health Clinic
BLDG 301 Andrews Ave
Ft Rucker, AL 36362-5333
Mailing address
Lyster Army Health Clinic
BLDG 301 Andrews Ave
Ft Rucker, AL 36362-5333
Phone (334) 255-7032
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
- Credentials
- Emergency Medical Technician - Paramedic
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0800998 | AL | MD | Paramedic |
| P8009774 | AL | MD | Paramedic |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246406400000",
"number": "1356579098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LYSTER ARMY HEALTH CLINIC",
"address_2": "BLDG 301 ANDREWS AVE",
"city": "FT RUCKER",
"state": "AL",
"postal_code": "363625333",
"telephone_number": "334-255-7032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LYSTER ARMY HEALTH CLINIC",
"address_2": "BLDG 301 ANDREWS AVE",
"city": "FT RUCKER",
"state": "AL",
"postal_code": "363625333",
"telephone_number": "334-255-7032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "DERRICK",
"middle_name": "MONROE",
"credential": "EMT-P",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-01",
"last_updated": "2009-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "146L00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Paramedic",
"state": "AL",
"license": "P8009774",
"primary": true
},
{
"code": "146L00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Paramedic",
"state": "AL",
"license": "0800998",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.