Derrick L. Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G50178 Issued in CA

Practice address

69730 Highway 111 Ste 109
Rancho Mirage, CA 92270-2873

Phone

(760) 778-6120

Fax

(760) 406-6077

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Derrick L. Smith Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Bartz-Altadonna Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1811279763

  Multi-Specialty

  Medicare reassignment NPD
• Hearth Stone House, Inc

  • Substance Abuse Rehabilitation Facility
  • Palm Desert, CA
  • NPI 1376913483
  NPD (past) Authorized official
• Bartz-Altadonna Community Health Center

  • Community/Retail Pharmacy
  • Lancaster, CA
  • NPI 1700672011
  NPD
• J.Herndons, LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Rancho Mirage, CA
  • NPI 1427486158
  NPD

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1780679894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1642",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925951642",
            "telephone_number": "877-240-3645",
            "fax_number": "951-609-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69730 HIGHWAY 111 STE 109",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702873",
            "telephone_number": "760-778-6120",
            "fax_number": "760-406-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DERRICK",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G50178",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G50178",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G50178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DERRICK",
            "last_name": "SMITH",
            "middle_name": "L.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sleepmed Therapies, Inc
• Natalie Michelle Sloan, F.N.P.
• SM Wolfram DDS Inc
• Jessica Zarathena Smeaton, MD
• Barbara Rochelle Smith
• Donna Faye Smith, R.N., F.N.P.
• Gerard Smith, FNP
• Heather E Smith
• Mark Q. Smith, MD
• Matthew J. Smith, P.A.-C

• Family Medicine Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2024; 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.