Henry Clark Deriso, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

013026 Issued in GA

Practice address

38 Medical Arts Ctr
Savannah, GA 31405-4415

Phone

(912) 692-0755

Fax

(912) 692-0754

NPI assigned

Sep 21, 2006

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1770682403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 MEDICAL ARTS CTR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054415",
            "telephone_number": "912-692-0755",
            "fax_number": "912-692-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 MEDICAL ARTS CTR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054415",
            "telephone_number": "912-692-0755",
            "fax_number": "912-692-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISO",
        "first_name": "HENRY",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "013026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora C. Denton, MD
• Department of Behavioral Health & Developmental Disabilities (Georgial Regional Hospital at Savannah)
• Amber N Depew
• Taylor Depol, RBT
• Deborah Depue, SLP
• Caroline Banta Derosa, APRN
• Derrell W. Ray M.D. P.C.
• Astha Desai
• Nikita Desai
• Candace Lucene Deshler, LPMT, MT-BC

• Specialist in Savannah, GA
• Providers in Savannah, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.