Active NPI
Derrick Ray Havin, M.D.
- Obstetrics & Gynecology Physician
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD0046334
- Practice address
- 101 W 8TH Ave Ste 1300
Spokane, WA 99204-2307 - Phone
- (509) 474-7370
- Fax
- (509) 474-7372
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD0046334 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave Ste 1300
Spokane, WA 99204-2307
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8457327 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Saint Louis University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 W 8TH Ave
Suite 1300
Spokane, WA 99204-2307
Phone (509) 474-7370
Hospital & facility affiliations
- Prov Sacred HRT Med Ctr & Childs Hosp.
- Providence Holy Family Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0046334 | WA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current | Accepting new patients | |
| Providence Health & Services Washington | Current | Accepting new patients | |
| SSM Health Care St. Louis | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
101 W 8th Ave
Ste 1300
Spokane, WA 99204
Phone (509) 474-2444
Organizations & group practices 3
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.
-
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
-
- Family Medicine Physician
- Colville, WA
- NPI 1083968879
-
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
Obstetrics & Gynecology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Spokane, WA
- NPI 1144471715
-
- General Acute Care Hospital
- Spokane, WA
- NPI 1225289895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1467563304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "866-747-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE STE 1300",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-474-7370",
"fax_number": "509-474-7372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVIN",
"first_name": "DERRICK",
"middle_name": "RAY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WA",
"license": "MD0046334",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8457327",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.