Individual provider Active NPI

Derek Brady Covington, M.D.

  • Anesthesiology Physician
  • Gainesville, FL
National Provider Identifier
1649562091
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME123807 Issued in FL
Practice address
1600 SW Archer Rd
Box 100371
Gainesville, FL 32610-0371
Phone
(352) 265-0301
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X ME123807 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Box 100371
Gainesville, FL 32610-0371

Mailing address

2301 Erwin Rd
Durham, NC 27705-4699

Other identifiers 1

IdentifierTypeStateIssuer
017818800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210108000641 NC Practitioner - Anesthesiology 4284941519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nevada School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

Hospital & facility affiliations

  • Watauga Medical Center Hospital, Boone, NC, CCN 340051
  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135363CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Oct 1, 2024 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Apr 1, 2024 Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 2

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 2

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1649562091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100371",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100371",
            "telephone_number": "352-265-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVINGTON",
        "first_name": "DEREK",
        "middle_name": "BRADY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME123807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017818800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.