Active NPI
Gerard Derisse, MD
- Psychiatry Physician
- Larned, KS
National Provider Identifier
1447290200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0800282
- Practice address
- 1301 KS Hwy 264
Larned, KS 67550-5353 - Phone
- (620) 285-4115
- Fax
- (620) 285-4579
- NPI assigned
- Jun 8, 2006
- Last updated
- Aug 5, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0800282 | KS | Primary |
Addresses
Primary practice location
1301 KS Hwy 264
Larned, KS 67550-5353
Mailing address
1301 KS Hwy 264
Larned, KS 67550-5353
Phone (620) 285-4115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0800282 | KS | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217894400000",
"number": "1447290200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 KS HWY 264",
"city": "LARNED",
"state": "KS",
"postal_code": "675505353",
"telephone_number": "620-285-4115",
"fax_number": "620-285-4579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 KS HWY 264",
"city": "LARNED",
"state": "KS",
"postal_code": "675505353",
"telephone_number": "620-285-4115",
"fax_number": "620-285-4579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERISSE",
"first_name": "GERARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2008-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": "0800282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Larned, KS
- Ashley Coss, DPT
- Country Place Living
- County of Pawnee (Pawnee County Health Department)
- County of Pawnee
- Stephen E. Dent, D.C.
- Louis R. Derose, M.D.
- Diversicare of Larned LLC (Diversicare of Larned)
- Dr. Douglas D. Ayre Optometrist P a (Larned Eye Health)
- Logan Duerksen, A.P.R.N.
- Walter I Dumorne, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.