Derek E Slack, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

41000366A Issued in IN

Practice address

3801 Bellemeade Ave Ste 110
Evansville, IN 47714-0111

Phone

(812) 485-7330

NPI assigned

Jul 10, 2017

Last updated

Jul 10, 2017By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athens Physicians Practice LLCGroup PAC ID 2163490319, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Athens Physicians Practice, LLC

  dba Starr Orthopedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Athens, TN
  • NPI 1689055774
  Medicare reassignment Care Compare group NPD
• Athens Physicians Practice LLC

  dba Starr Regional Family Practice - Etowah

  • Rural Health Clinic/Center
  • Etowah, TN
  • NPI 1508627175
  NPD
• Athens Physicians Practice LLC

  dba William R. Bowers MD

  • Family Medicine Physician
  • Athens, TN
  • NPI 1073532123
  NPD (past)

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

• Athens Regional Medical Center LLC

  dba Starr Regional Medical Center

  • General Acute Care Hospital
  • Athens, TN
  • NPI 1669567319
  Care Compare affiliation

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1437671740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 BELLEMEADE AVE STE 110",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BELLEMEADE AVE STE 110",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140111",
            "telephone_number": "812-485-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "DEREK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "41000366A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Ann Skeels, PTA
• Jonathan Skeels
• Elizabeth Skelton, CMT
• Christine Skeoch, RPH
• Karen Anne Skinner, RN
• Sleep Medicine Associates P. C.
• Richard P Sloan, M.D.
• Emily Slone, PHARMD
• Maddix Ray-Ann Small
• Michanne Smiddy, PTA

• Foot & Ankle Surgery Podiatrist in Evansville, IN
• Providers in Evansville, IN by specialty
• Foot & Ankle Surgery Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.