Kathy Derrick, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209011668 Issued in IL

Practice address

1760 E Pecos Rd Ste 102
Gilbert, AZ 85295-3201

Phone

(480) 690-8412

NPI assigned

Jul 28, 2014

Sex

Female

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 AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathy.derrick.1@19654.direct.athenahealth.com
• Direct secure messaging: kderrickaprn316399@carlehiedirect.net

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1922532944
  Medicare reassignment NPD
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Columbia, MD
  • NPI 1811765449
  NPD
• Centerwell Senior Primary Care Az PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1063169316
  NPD (past)
• Centerwell Senior Primary Care Az PC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1497401830
  NPD (past)
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1689082174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4366 S AVENIDA DE ANGELES",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851182976",
            "telephone_number": "217-521-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD STE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953201",
            "telephone_number": "480-690-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "KATHY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Christine Deramus, MA, BCBA, LBA
• Jourdan Derden, LPC
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• Corinne Pirson Derosa, LCSW
• Jessica L Dery, PMHNP
• Desert Behavioral Health PC
• Desert Bloom Birth Center LLC
• Desert Dermatology & Skin Cancer Specialists, P.C.
• Desert Dolphin Aquatic Therapy & Rehab

• Family Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.