Active NPI
Bonnie L Derby, L.C.S.W.
- Clinical Social Worker
- Sioux City, IA
National Provider Identifier
1831297886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 01139
- Practice address
- 3002 Nordic CT
Sioux City, IA 51104-2840 - Phone
- (712) 253-7426
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 991921 | CO | |
| Clinical Social Worker | 1041C0700X | 01139 | IA | Primary |
Addresses
Primary practice location
3002 Nordic CT
Sioux City, IA 51104-2840
Mailing address
3002 Nordic CT
Sioux City, IA 51104-2840
Phone (712) 253-7426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991921 | CO | MD | Clinical Social Worker |
| 01139 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738886400000",
"number": "1831297886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3002 NORDIC CT",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511042840",
"telephone_number": "712-253-7426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3002 NORDIC CT",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511042840",
"telephone_number": "712-253-7426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBY",
"first_name": "BONNIE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2025-02-07",
"certification_date": "2025-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "991921",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "01139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.