Individual provider Active NPI

Derron Terrell Hines

  • Attendant Care Provider
  • Florissant, MO
National Provider Identifier
1871477042
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
License
3747A0650X Issued in MO
Practice address
12464 Partridge Run Dr
Florissant, MO 63033-5008
Phone
(314) 637-6649
NPI assigned
Aug 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X 3747A0650X MO Primary

Addresses

Primary practice location

12464 Partridge Run Dr
Florissant, MO 63033-5008

Mailing address

12464 Partridge Run Dr
Florissant, MO 63033-5008
Phone (314) 637-6649

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

LicenseStateTypeSpecialty
3747A0650XMOMDAttendant Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1871477042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12464 PARTRIDGE RUN DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630335008",
            "telephone_number": "314-637-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12464 PARTRIDGE RUN DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630335008",
            "telephone_number": "314-637-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "DERRON",
        "middle_name": "TERRELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "MO",
            "license": "3747A0650X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.

Verify at the official NPI Registry.