Derek A West

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

PHCP011562 Issued in GA

Practice address

500 Windsor Way
Fairburn, GA 30213-6446

Phone

(404) 786-8598

NPI assigned

May 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

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.

• Caregistics of Georgia LLC

  • Registered Nurse
  • Fairburn, GA
  • NPI 1346989068
  NPD

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1821734856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDSOR WAY",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302136446",
            "telephone_number": "404-786-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDSOR WAY",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302136446",
            "telephone_number": "404-786-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "DEREK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "PHCP011562",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "PHCP011562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashunda Ward
• Leslie Ward
• Gwendolyn M Washington
• Jessica Leigh Wasson, PA-C
• Wellstreet of Georgia PC
• Sandra West, REGISTERED NURSE
• Stephanie Westbrook, LPC
• Javonne McKoy White, D.D.S.
• Kennedy White
• Robert Lee White Jr., D.D.S.

• Nurse's Aide in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Nurse's Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.