Derick Mordus, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

6367 Issued in TN

Practice address

1000 S Gateway Blvd
Clarksville, TN 37043-8118

Phone

(931) 552-4340

Fax

(931) 552-0999

NPI assigned

Feb 28, 2014

Last updated

Jul 8, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WA, TN2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tennessee Orthopaedic Alliance PAGroup PAC ID 5193625069, 358 clinicians

Electrodiagnosis and Rehabilitation Associates of Tacoma PSGroup PAC ID 5597652677, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derick.mordus.p1@direct.toa.nextgenshare.com

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.

• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Nashville, TN
  • NPI 1538153937
  Medicare reassignment Care Compare group NPD
• Electrodiagnosis & Rehabilitation Associates of Tacoma, PS

  • Specialist
  • Tacoma, WA
  • NPI 1508821422
  Medicare reassignment Care Compare group NPD
• Tennessee Orthopaedic Alliance PA

  • Multi-Specialty Clinic/Center
  • Clarksville, TN
  • NPI 1336905561
  NPD
• Tennessee Orthopaedic Alliance PA

  dba Tennessee Orthopaedic Alliance

  • Orthopaedic Surgery Physician
  • Smyrna, TN
  • NPI 1205820610
  NPD (past)

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1861817785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306556",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306556",
            "telephone_number": "615-329-2294",
            "fax_number": "615-695-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S GATEWAY BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438118",
            "telephone_number": "931-552-4340",
            "fax_number": "931-552-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98433",
            "country_code": "US",
            "telephone_number": "253-968-6968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "425-445-8924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORDUS",
        "first_name": "DERICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-28",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NE",
            "license": "1346",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "6367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Moore, MD
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• Carlisha Symia Moragne
• Jacquelyn Suzanne Morales
• Joshua Morales
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• Juliany Enis Moreno, RBT
• Amanda Gail Morgan, APRN, PMHNP-BC
• Ashmarah Morgan
• Tara Dee Morgan

• Physical Medicine & Rehabilitation Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physical Medicine & Rehabilitation Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.