NPIMap

Individual provider Active NPI

Derrick L. Ross, EMT-P

  • Paramedic
  • Albuquerque, NM
National Provider Identifier
1861747230
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
00014425 Issued in NM
Practice address
1515 Eubank Blvd SE
BLDG 831
Albuquerque, NM 87185-1019
Phone
(505) 844-4237
NPI assigned
Jul 20, 2012
Last updated
Jul 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X 00014425 NM Primary

Addresses

Primary practice location

1515 Eubank Blvd SE
BLDG 831
Albuquerque, NM 87185-1019

Mailing address

1515 Eubank Blvd SE
BLDG 831
Albuquerque, NM 87185-1019
Phone (505) 844-4237

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
Credentials
Emergency Medical Technician - Paramedic

State licenses

LicenseStateTypeSpecialty
00014425NMMDParamedic

Practice roles

OrganizationSpecialtyStatusNew patients
Sandia National Laboratories Past Accepting new patients
International Travel Clinic Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1861747230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 EUBANK BLVD SE",
            "address_2": "BLDG 831",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871851019",
            "telephone_number": "505-844-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 EUBANK BLVD SE",
            "address_2": "BLDG 831",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871851019",
            "telephone_number": "505-844-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "DERRICK",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "EMT-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "NM",
            "license": "00014425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.