Michael Derrick, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01082585A Issued in IN

Practice address

1100 Reid Pkwy
Reid Hospital & Health Care Services
Richmond, IN 47374

Phone

(765) 983-3492

Fax

(765) 983-7958

NPI assigned

Jun 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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 Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mderrick343662@reidhealth.direct-ci.com
• Direct secure messaging: mike.derrick.p1@direct.tannerclinic.nextgenshare.com

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.

• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355

  Pediatrics

  Medicare reassignment NPD
• Tanner Memorial Clinic

  dba Tanner Clinic Layton South

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Tanner Memorial Clinic

  • Gastroenterology Physician
  • Ogden, UT
  • NPI 1609406511
  NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1790133734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-935-8807",
            "fax_number": "765-935-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "REID HOSPITAL & HEALTH CARE SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-983-3492",
            "fax_number": "765-983-7958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_2": "HD408",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "801-362-1718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01082585A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mderrick343662@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "address_2": "Reid Hospital & Health Care Services",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Skylar Delaney
• Carla Jean Delawder, RN
• Dental Professionals of Indiana, P.C. (Whitewater Valley Dental)
• Dental Professionals of Indiana, P.C. (Richmond Family Dentistry)
• Dermatheric LLC
• David Desantis, M.D., PH.D
• Kylee Desonie, RBT
• Ajit Dhakal
• Rajesh Dhakal, M.D.
• Ramandeep Kaur Dhillon-Gill, D.O.

• Pediatrics Physician in Richmond, IN
• Providers in Richmond, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.