James L Derrick, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110008289 Issued in VA

Practice address

1802 Braeburn Dr
Salem, VA 24153-7357

Phone

(540) 772-3530

Fax

(540) 776-2036

NPI assigned

Sep 21, 2006

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 NC, VA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jderrick@brbj.gwaydirect.com

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.

• Lewis Gale Physicians LLC

  • Internal Medicine Physician
  • Salem, VA
  • NPI 1902977705
  Medicare reassignment Care Compare group

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

• Lewis-Gale Medical Center, LLC

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1457459448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR FL HP2",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3530",
            "fax_number": "540-776-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110008289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Associates PLLC
• Dental Professionals of Virginia, P.C.
• Department of Veterans Affairs
• Scott Alan Depoe, O.D.
• Diane L Dereu-Foley, D.C.
• Victoria Belle Desantis, PHARMD
• Mark Budd Detweiler, MD
• Alexandra Detzler, LCSW
• Devasmita Choudhury Dev, M. D.
• William Harold Devereaux IV, CRNA

• Surgical Physician Assistant in Salem, VA
• Providers in Salem, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.