Pamela Derbyshire, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11016599 Issued in FL

Practice address

6700 S Florida Ave Ste 33
Lakeland, FL 33813-3312

Phone

(863) 450-3067

Fax

(863) 337-4123

NPI assigned

Dec 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Yantra Psychiatric Services, Inc.

  • Psychiatry Physician
  • Lakeland, FL
  • NPI 1528588878
  NPD

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1831786425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 S FLORIDA AVE STE 33",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133312",
            "telephone_number": "863-450-3067",
            "fax_number": "863-337-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 S FLORIDA AVE STE 33",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133312",
            "telephone_number": "863-450-3067",
            "fax_number": "863-337-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBYSHIRE",
        "first_name": "PAMELA",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11016599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pderby@yantracares.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6700 S Florida Ave Ste 33",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338133312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tony Lawson Denton, H.A.S.
• Cynthia Deokarran, PHARMD
• Mariah Korinna Depass, RMHCI
• Jennifer Depew, DMD
• Cody Derby, LAT, ATC
• Derenees LLC
• Nardin Derias, MD
• Dermatology Associates of Central Florida PA
• Melissa F Deroxtro, LCSW
• Devyani N Desai, MD

• Psychiatric/Mental Health Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.