Individual provider Active NPI

Coda Derrig, PH.D.

  • Psychologist
  • Akron, OH
National Provider Identifier
1538545355
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7324 Issued in OH
Practice address
1 Akron General Ave
Akron, OH 44307-2432
Phone
(330) 344-6525
Fax
(330) 996-2943
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7324 OH Primary

Addresses

Primary practice location

1 Akron General Ave
Akron, OH 44307-2432

Mailing address

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6525

Other identifiers 4

IdentifierTypeStateIssuer
0140343MedicaidOH
1841239274OtherOHPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
9338635OtherOHPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
2551671OtherOHPARTNERS PHYSICIAN GROUP MEDICAID GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831001982 OH Practitioner - Clinical Psychologist 7810203205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners Physician GroupGroup PAC ID 4183529340, 409 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-1967

Hospital & facility affiliations

  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7324OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Partners Physician Group CurrentSince Aug 5, 2015 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Partners Physician Group CurrentSince Aug 5, 2015 Accepting new patients
Partners Physician Group Past Accepting new patients
Partners Physician Group Past Accepting new patients

Locations

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

Interoperability endpoints

  • Direct secure messaging: cderrig391801@direct.ccf.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1538545355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432",
            "telephone_number": "330-344-6525",
            "fax_number": "330-996-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432",
            "telephone_number": "330-344-6525",
            "fax_number": "330-996-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRIG",
        "first_name": "CODA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "7324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0140343",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #",
            "identifier": "1841239274",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #",
            "identifier": "9338635",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICAID GROUP #",
            "identifier": "2551671",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.