Karly Anne Derwitz, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LL83483 Issued in SC

Practice address

Prisma Health Children'S Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203

Phone

(803) 434-6155

Fax

(803) 434-6979

NPI assigned

May 17, 2021

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: kdubs813598@direct.vumc.org

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1720652472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
            "address_2": "14 MEDICAL PARK, STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
            "address_2": "14 MEDICAL PARK, STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERWITZ",
        "first_name": "KARLY",
        "middle_name": "ANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL83483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Derr, RN
• Allyson Derrick
• Brandi L Derrick, MD
• Suzanne Derrick, RPH
• Amy Renee Derry, FNP-C
• Devang Harshad Desai, D.M.D.
• Jordan Desai, LISW-CP
• Merrie Jo Desai, CRNA
• Nehal T Desai, MD
• Desautels Family Eye Care LLC

• Pediatrics Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.