Dereck Ivey

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30869 Issued in MD

Practice address

801 Toll House Ave Ste H3
Frederick, MD 21701-6117

Phone

(240) 575-9260

NPI assigned

Jun 1, 2026

Last updated

Jun 12, 2026By 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 MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Red Canyon, LLC

  • Physical Therapist
  • Frederick, MD
  • NPI 1952768673
  Medicare reassignment
• Red Canyon, LLC

  • Physical Therapist
  • Frederick, MD
  • NPI 1134660954
  NPD (past)
• Red Canyon, LLC

  • Physical Therapist
  • Martinsburg, WV
  • NPI 1841872405
  NPD (past)

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1447182845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 TOLL HOUSE AVE STE H3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TOLL HOUSE AVE STE H3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016117",
            "telephone_number": "240-575-9260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Baughmans Ln Ste 160",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024946",
            "country_code": "US",
            "telephone_number": "240-651-1335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9093 Ridgefield Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016712",
            "country_code": "US",
            "telephone_number": "410-855-4855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 John Simmons St Ste A203",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "MD",
            "postal_code": "217047964",
            "country_code": "US",
            "telephone_number": "301-882-8382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12916 Conamar Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422760",
            "country_code": "US",
            "telephone_number": "301-665-3731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVEY",
        "first_name": "DERECK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Lee Isaac, D.P.M.
• Robin Isaacson
• Elizabeth Ann Isleib, RBT
• Nareh Issayans, DDS
• Harvey Zachary Itskowitz, M.D.
• Rosalie Iyelie, NP
• J. Christopher Henry, M.D., LLC (Central Maryland Oculoplastic Consultants)
• J's Compassionate Care LLC.
• Maya Jaajah
• Danah Jack, PT

• Physical Therapist in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.