Derrick R Eddy, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C002970 Issued in AR

Practice address

2601 Gene George Blvd
Springdale, AR 72762-0845

Phone

(479) 725-6800

NPI assigned

Jun 16, 2010

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Services of Benton County PA

  • Anesthesiology Physician
  • Rogers, AR
  • NPI 1013084482
  Medicare reassignment NPD
• Arkansas Childrens Hospital

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• Arkansas Children'S Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • General Practice Physician
  • Little Rock, AR
  • NPI 1336533041
  NPD
• Anesthesia Associates of Lima Inc

  • Certified Registered Nurse Anesthetist
  • Lima, OH
  • NPI 1487662300

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1720309511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 Rife Medical Ln",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727581452",
            "country_code": "US",
            "telephone_number": "913-642-4900 x247",
            "fax_number": "913-381-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDDY",
        "first_name": "DERRICK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1720309511",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01278937",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ARKANSAS",
            "identifier": "5UU07",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198801001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200494180A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720309511",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrystal Lee Eastridge, MHPP
• Hannah Eaves
• Guadalupe Eck
• Steven D Eckard
• Economic Opportunity of Washington County, Inc
• Ayeisha Edgin
• Donna Mansueto Edgmon, CCC-SLP
• Michelle Leigh Edmiston
• Ashley Elizabeth Edwards, OT
• Cara Edwards

• Certified Registered Nurse Anesthetist in Springdale, AR
• Providers in Springdale, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.