Kevin Deidrick

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

692126 Issued in TX

Practice address

2401 S 31St St
Temple, TX 76508-0001

Phone

(254) 935-5750

NPI assigned

Mar 28, 2021

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

R Franklin University of Med & Sci/Chicago Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of College Station Home health agency, College Station, TX, CCN 679189
• Baylor Scott & White Hospital Brenham Hospital, Brenham, TX, CCN 451397
• Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088
• Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdeidrick828472@direct.sw.org

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.

• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment Care Compare group NPD
• Scott & White Hospital Brenham

  dba Baylor Scott & White Medical Center - Brenham

  • Critical Access Hospital
  • Brenham, TX
  • NPI 1154315307
  Medicare reassignment
• Scott & White Hospital Brenham

  • Internal Medicine Physician
  • Brenham, TX
  • NPI 1295464949
  Medicare reassignment
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

• Scott & White Hospital - College Station

  dba Baylor Scott & White Medical Center - College Station

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1265772362
  Care Compare affiliation
• Scott & White Hospital Brenham

  dba Baylor Scott & White Medical Center - Brenham

  • Critical Access Hospital
  • Brenham, TX
  • NPI 1154315307
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Baylor Scott & White Medical Center - Temple

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Kings's Daughters Hospital- Scott & White Healthcare

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1578502613
  Care Compare affiliation
• Texas Home Health Group of College Station, LLC

  dba AccentCare Home Health of College Station

  • Home Health Agency
  • College Station, TX
  • NPI 1720518178
  Care Compare affiliation

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1538746110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "916-390-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-935-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIDRICK",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TX",
            "license": "692126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niloyjyoti Deb, MD
• Sarah Beth Debus, PA-C
• Chantelle Marie Decroff, MD
• Augustine Joseph Deering III, MD
• John Austin Dees, CRNA
• Alaina Kay Dekeratry, MS, RD, LD
• Lisa Marie Delarosa, M.D.
• Brandon Delavar
• Jessica Janise Delia, M.S., CCC-SLP
• Maria Downing Delk, M.A.

• Primary Podiatric Medicine Podiatrist in Temple, TX
• Providers in Temple, TX by specialty
• Primary Podiatric Medicine Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.