Derek J Cripps LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

15388 Issued in WI

Legal business name

DEREK J CRIPPS LLC

Practice address

2817 New Pinery Rd
Portage, WI 53901-9257

Phone

(608) 745-5093

NPI assigned

Oct 30, 2008

Last updated

Oct 30, 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. Derek James Cripps, M.D.

Title

Emeritus Professor of Medicine

Phone

(608) 244-1712

Specialties & licenses 1

Addresses

Other names 1

• Derek J Cripps MD LLC Other name

Locations

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1659524981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 WILDER DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537046011",
            "telephone_number": "608-244-1712",
            "fax_number": "608-244-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019257",
            "telephone_number": "608-745-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK J CRIPPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "CRIPPS",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "EMERITUS PROFESSOR OF MEDICINE",
        "authorized_official_telephone_number": "608-244-1712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WI",
            "license": "15388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derek J Cripps MD LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nichole Decorah, LPC-IT
• Timothy A Mical Deering, MD
• Robin A Deethardt, LPC
• Kelsey Deets
• Jennelle Marie Denoyer, P.T.
• Emily E Desjarlais
• Jill Dickson-Baures, PSY. D.
• Kelly Lee Dittberner
• Divine Savior Healthcare
• Divine Savior Healthcare

• Medical Specialty Clinic/Center in Portage, WI
• Providers in Portage, WI by specialty
• Medical Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.