Jeffrey Lee Derry, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

123709 Issued in NC

Practice address

Old Highway 75 Fci II Butner
Health Services Unit
Butner, NC 27509-1000

Phone

(919) 575-8000

NPI assigned

Jan 3, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710044276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MEADOW BROOK LN",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275652870",
            "telephone_number": "919-690-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OLD HIGHWAY 75 FCI II BUTNER",
            "address_2": "HEALTH SERVICES UNIT",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091000",
            "telephone_number": "919-575-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRY",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "123709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Anna Cyr, LCSW
• Farah Lindley Davis, P-LCSW
• Wilhelmina J.Griep De Marchi, M.D.
• Adrienne Rose Dekay, P-LCSW
• Alexa Danielle Delisle, PHD
• Anna Destino
• Asenath Anne Devaney, PH.D.
• Nancy Di Maio, PHARMD
• Joel Andrew Dillon, PSYD
• Cameron Allison Dubois, MSW, LCSW-A

• All providers in Butner, NC
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.