Dawn Marie Derks, ACNS-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

15001-33 Issued in WI

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(651) 254-3665

NPI assigned

Sep 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Medical Center IncGroup PAC ID 8022000447, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tamarack Health Ashland Medical Center Hospital, Ashland, WI, CCN 521359

Merit-based Incentive Payment System (MIPS)

Final score

86.19 of 100Reported as group

Quality

74.89

Promoting interoperability

100

Improvement activities

40

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 and National Provider Directory roles.

• Memorial Medical Center Inc

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment Care Compare group NPD
• Memorial Medical Center Inc

  • Rural Health Clinic/Center
  • Ashland, WI
  • NPI 1770255937
  NPD

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

• Memorial Medical Center Inc

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Care Compare affiliation

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

{
    "created_epoch": "1411257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1396147377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063626",
            "telephone_number": "715-685-5500",
            "fax_number": "715-682-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKS",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "ACNS-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-21",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MN",
            "license": "2014005854",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15001-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C02467",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Depauw
• Neil M Derechin, MD
• Derheim, Inc
• Courtney Dering, LGSW
• Ashley Derjani, CNP
• Eric Derocher, DO
• Rhonda Lynn Derosier, PT
• Georgii Deryabin
• Keyur Desai, PSYD, LP
• Shireen Elizabeth Desamlazaro, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

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