Active NPI
Derek Roland Foreman, D.C.
- Rehabilitation Chiropractor
- Pahrump, NV
National Provider Identifier
1700936101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- B00810
- Practice address
- 2080 E. Calvada Blvd.#100
Pahrump, NV 89048-5844 - Phone
- (775) 537-6110
- Fax
- (775) 537-6151
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | B00810 | NV | Primary |
Addresses
Primary practice location
2080 E. Calvada Blvd.#100
Pahrump, NV 89048-5844
Mailing address
2080 E. Calvada Blvd.#100
Pahrump, NV 89048-5844
Phone (775) 537-6110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B00810 | NV | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1700936101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2080 E. CALVADA BLVD.#100",
"city": "PAHRUMP",
"state": "NV",
"postal_code": "890485844",
"telephone_number": "775-537-6110",
"fax_number": "775-537-6151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 E. CALVADA BLVD.#100",
"city": "PAHRUMP",
"state": "NV",
"postal_code": "890485844",
"telephone_number": "775-537-6110",
"fax_number": "775-537-6151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOREMAN",
"first_name": "DEREK",
"middle_name": "ROLAND",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "NV",
"license": "B00810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pahrump, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.