Derek C Lish, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

TEMP RNA 19861 Issued in ID

Practice address

950 Medical Dr
Brigham City, UT 84302-4724

Phone

(435) 734-9471

NPI assigned

Feb 9, 2009

Last updated

Oct 26, 2021By the provider in NPPES

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 UT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Brigham Anesthesia, LLCGroup PAC ID 9335108299, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017
• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brigham Anesthesia, LLC

  • Anesthesiology Physician
  • Brigham City, UT
  • NPI 1710904800
  Medicare reassignment Care Compare group NPD
• NPH Anesthesia of Utah, LLC

  • Anesthesiology Physician
  • Ogden, UT
  • NPI 1366077273
  Medicare reassignment Care Compare group NPD
• Boise Anesthesia, P a

  • Anesthesiology Physician
  • Boise, ID
  • NPI 1487602298

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Boise Anesthesia, PA

  • Anesthesiology Physician
  • Boise, ID
  • NPI 1740239599
  NPD (past)

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

• Brigham City Community Hospital, Inc.

  dba Brigham City Community Hospital

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1699914044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4268",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084268",
            "telephone_number": "503-372-2740",
            "fax_number": "503-373-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MEDICAL DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024724",
            "telephone_number": "435-734-9471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5475 S 500 E",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844056905",
            "country_code": "US",
            "telephone_number": "801-479-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISH",
        "first_name": "DEREK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-09",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "TEMP RNA 19861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Elevated Physical Therapy
• Life-Skills and Individual Needs Center
• Benjamin Limb
• Limitless Physical Therapy PLLC
• Brooks Warner Linberg
• Jeffrey R Lish, M.D.
• Amelia Littlefield, PA-C
• Kayla Livingston
• Carey Deyoung Lloyd, M.D.
• Cody Lloyd

• Certified Registered Nurse Anesthetist in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.