Maria Johnston Derryberry, ANP-BC

Individual provider Active NPI Adult Health Nurse Practitioner · Kamuela, HI

NPI 1487945317 · NPPES record last updated May 28, 2021

Key facts

NPI
1487945317
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
APRN-1346 (HI)
Practice address
65-1158 Mamalahoa Hwy Ste 8a
Kamuela, HI 96743-8442
Phone
(808) 740-5700
Fax
(808) 442-0891
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kupuna Healthcare Services, LLC Adult Health Current
since Jun 22, 2021
Accepting new patients
Hawaii Health Systems Corporation Current
since Jun 28, 2012
Accepting new patients
Brighton Rehabilitation LLC Past
since Jun 28, 2012
Accepting new patients

Locations

1180 Waianuenue Ave
Hilo, HI 96720
Phone (808) 961-1500

206 N 2100 W
Slc, UT 84116
Phone (801) 532-4120

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP8329 AZ
Adult Health Nurse Practitioner 363LA2200X APRN-1346 HI Yes

Addresses

Primary practice location

65-1158 Mamalahoa Hwy Ste 8a
Kamuela, HI 96743-8442

Mailing address

65-1158 Mamalahoa Hwy Suite 8a PMB 157
Kamuela, HI 96743-8442
Phone (808) 740-5700

Other providers in Kamuela, HI

All providers in Kamuela, HI · Adult Health Nurse Practitioner in Hawaii

Sources for this page

Verify at the official NPI Registry.