Mallory Derrick, B.A.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1376977330 Issued in MN

Practice address

2410 Charlotte Ave
Nashville, TN 37203-1517

Phone

(615) 321-2575

Fax

(615) 327-4536

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

State licenses

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.

• Regions Hospital

  • Emergency Medicine Physician
  • Saint Paul, MN
  • NPI 1154359917
  Medicare reassignment

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1376977330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 CHARLOTTE AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 CHARLOTTE AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031517",
            "telephone_number": "615-321-2575",
            "fax_number": "615-327-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1376977330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence Dermody
• Ava Derr
• Gwynn Derrick
• Haevin Derrick, B.S.
• Joannah Derrick
• Alex Derry
• Hayley Andrews Derusha, FNP-C
• Adnan Dervishi, M.D.
• Anna S Dervishi, APRN
• Joy Derwenskus, DO

• Clinical Social Worker in Nashville, TN
• Providers in Nashville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.