NPIMap

Individual provider Active NPI

Derek Peckham, DO

  • Emergency Medicine Physician
  • Hays, KS
National Provider Identifier
1386374163
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0551633 Issued in KS
Practice address
2220 Canterbury Dr
Hays, KS 67601-2370
Phone
(785) 623-5555
NPI assigned
Jun 14, 2022
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0551633 KS Primary
Family Medicine Physician 207Q00000X 0551633 KS

Addresses

Primary practice location

2220 Canterbury Dr
Hays, KS 67601-2370

Mailing address

2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 623-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231017001410 NE Practitioner - Family Practice 5294118105 Reassigns benefits to 7 organizations
I20250908003350 KS Practitioner - Emergency Medicine 5294118105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hays Medical Center IncGroup PAC ID 1557279676, 188 clinicians

Practice addresses (Care Compare)

2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 623-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0551633KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hays Medical Center, Inc CurrentSince Sep 1, 2025 Accepting new patients
Jefferson Community Health Center Inc Family Medicine CurrentSince May 10, 2024 Accepting new patients
Regional West Garden County Family Medicine CurrentSince Apr 22, 2024 Accepting new patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Dec 22, 2023 Accepting new patients
Jefferson Community Health Center, Inc. Current Accepting new patients
Jennie M Melham Memorial Medical Center Inc Current Accepting new patients
Providence Medical Center CurrentSince Sep 20, 2023 Accepting new patients
Hays Medical Center, Inc. Current Accepting new patients
Providence Medical Center CurrentSince Sep 20, 2023 Accepting new patients
Hays Medical Center, Inc. Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Avera St Anthonys Hospital Current Accepting new patients
Jefferson Community Health Center Inc Family Medicine CurrentSince May 10, 2024 Accepting new patients
Jefferson Community Health Center, Inc. Current Accepting new patients

Locations

2220 Canterbury Dr
Hays, KS 67601
Phone (785) 623-5000

2200 H St
Fairbury, NE 68352
Phone (402) 729-3351

2200 H St
#277
Fairbury, NE 68352
Phone (402) 729-3351

4600 Valley Rd
Lincoln, NE 68510
Phone (402) 483-4571

1100 W 2nd St
Oshkosh, NE 69154
Phone (308) 772-3283

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

Interoperability endpoints

  • Direct secure messaging: derek.peckham.p1@direct.rwgcrhc.nextgenshare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1386374163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012370",
            "telephone_number": "785-623-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012370",
            "telephone_number": "785-623-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "0551633",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0551633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

Verify at the official NPI Registry.