Derek Shirley

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

HMEL. 11784 Issued in OH

Practice address

248 Beechnut St
Pickerington, OH 43147-7977

Phone

(740) 521-9475

NPI assigned

Dec 18, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Deco Scientific LLC

  • Durable Medical Equipment & Medical Supplies
  • Pickerington, OH
  • NPI 1851849467
  NPD (past) Authorized official

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1750746657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 LONG RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109635",
            "telephone_number": "614-388-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 BEECHNUT ST",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477977",
            "telephone_number": "740-521-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "DEREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-18",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "HMEL. 11784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME MEDICAL EQUIPMENT SERVICE PROVIDER LICENSE",
            "identifier": "HMEL. 11784",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazmine Brianna Shelton, STNA
• Linda Diane Shelts, RN
• Katherine Shevelson, MD
• Dawn M Shimp
• Cara Shirley, PT
• Abimbola A Shofu, M.D
• Morgan Elyse Shriver
• Jessica Elaine Shuler
• Marie Koenig Siddle, PA-C
• Karli Sidwell

• Durable Medical Equipment & Medical Supplies in Pickerington, OH
• Providers in Pickerington, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.