Derkash Professional, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

22420 Issued in CO

Legal business name

DERKASH PROFESSIONAL, LLC

Practice address

1906 Blake Ave
Glenwood Springs, CO 81601-4298

Phone

(970) 945-8683

NPI assigned

Aug 11, 2006

Last updated

Mar 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert S Derkash, M.D.

Title

Member/Manager

Phone

(970) 945-9702

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1609888650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10918 COUNTY ROAD 245",
            "city": "NEW CASTLE",
            "state": "CO",
            "postal_code": "816479410",
            "telephone_number": "970-984-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014298",
            "telephone_number": "970-945-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERKASH PROFESSIONAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "DERKASH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "970-945-9702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "22420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.