NPIMap

Individual provider Active NPI

Derrick H Williams, D.O.

  • Family Medicine Physician
  • Berea, KY
National Provider Identifier
1780966408
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03671 Issued in KY
Practice address
305 Estill St
4TH Floor
Berea, KY 40403-1742
Phone
(859) 986-2343
Fax
(859) 986-2344
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 03671 KY Primary

Addresses

Primary practice location

305 Estill St
4TH Floor
Berea, KY 40403-1742

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other identifiers 1

IdentifierTypeStateIssuer
7100253400MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220210001720 KY Practitioner - Family Practice 8628210499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians
Saint Joseph Health System IncGroup PAC ID 4183641400, 37 clinicians

Practice addresses (Care Compare)

116 Meridian Way
Richmond, KY 40475-2876
Phone (859) 623-6334

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-2343

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Health System, Inc. CurrentSince Nov 3, 2021 Accepting new patients
Neurosurgical Associates PSC Current Accepting new patients
Saint Joseph Health Inc Past Accepting new patients
Saint Joseph Health System, Inc. Past Accepting new patients

Locations

305 Estill St
Fl 4
Berea, KY 40403
Phone (859) 986-2343

701 Bob O Link Dr
Ste 120
Lexington, KY 40504
Phone (859) 277-3137

Interoperability endpoints

  • Direct secure messaging: derrickwilliams@kysjhspe.allscriptsdirect.net
  • Direct secure messaging: dwilliams274731@direct.stlukeshealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1780966408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "address_2": "4TH FLOOR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-2343",
            "fax_number": "859-986-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DERRICK",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100253400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.