Active NPI
Katherine Wilson Derue, MD
- Pediatric Sleep Medicine Physician
- Ypsilanti, MI
National Provider Identifier
1497902589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Sleep Medicine Physician
- License
- 4301096026
- Practice address
- 5333 McAuley Dr
Ste 3111
Ypsilanti, MI 48197-1014 - Phone
- (734) 712-7688
- Fax
- (734) 712-7056
- NPI assigned
- Aug 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301096026 | MI | |
| Pediatric Sleep Medicine Physician | 2080S0012X | 4301096026 | MI | Primary |
Addresses
Primary practice location
5333 McAuley Dr
Ste 3111
Ypsilanti, MI 48197-1014
Mailing address
24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766
Other names 1
- Dr. Katherine Elizabeth Wilson
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Multispecialty Physicians, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1912941337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1497902589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR",
"address_2": "PO BOX 0446 LOBBY J",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484",
"telephone_number": "734-747-6766",
"fax_number": "734-222-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 MCAULEY DR",
"address_2": "STE 3111",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971014",
"telephone_number": "734-712-7688",
"fax_number": "734-712-7056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUE",
"first_name": "KATHERINE",
"middle_name": "WILSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301096026",
"primary": false
},
{
"code": "2080S0012X",
"taxonomy_group": "",
"desc": "Pediatrics, Sleep Medicine",
"state": "MI",
"license": "4301096026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "WILSON",
"middle_name": "ELIZABETH",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.