Kelly Marie Derganc, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2012035666 Issued in MO

Practice address

100 Mercy Way
Joplin, MO 64804-4524

Phone

(417) 556-2727

Fax

(785) 357-6589

NPI assigned

Aug 26, 2010

Last updated

Jun 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
• Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338
• Mercy Specialty Hospital Southeast Kansas Hospital, Galena, KS, CCN 170203
• Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kderganc761734@directc.mercy.net

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.

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment Care Compare group NPD
• Wound Care Plus, LLC

  • Specialist
  • Saint Louis, MO
  • NPI 1841657053
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Carthage

  • Critical Access Hospital
  • Carthage, MO
  • NPI 1003201955
  Care Compare affiliation
• Mercy Hospital Carthage

  dba Mercy McCune-Brooks Hospital

  • General Acute Care Hospital
  • Carthage, MO
  • NPI 1396012753
  Care Compare affiliation
• Mercy Hospital Joplin

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1700112745
  Care Compare affiliation
• Mercy Hospital Pittsburg Inc

  • General Acute Care Hospital
  • Pittsburg, KS
  • NPI 1639921430
  Care Compare affiliation
• Mercy Specialty Hospital Southeast Kansas

  • Special Hospital
  • Galena, KS
  • NPI 1992341473
  Care Compare affiliation

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1881900058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SW MULVANE ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061677",
            "telephone_number": "785-357-0301",
            "fax_number": "785-357-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-2727",
            "fax_number": "785-357-6589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 NW South Outer Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640153069",
            "country_code": "US",
            "telephone_number": "888-256-3814",
            "fax_number": "888-256-9054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERGANC",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "141458",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012035666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "068002116",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200674390B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Dennis, DMD
• Kimberly Jo Dent, FNP
• Cole Austin Denton, PT, DPT
• Robert Michael Denton
• John M. Derfelt, DNP, APRN, FNP-C
• Jonathon Derryberry
• Hetvi Desai, D.O.
• Neha Nilesh Desai, DO
• Stacy R. Desutter, M.S., CCC-SLP
• Amanda W Detar, DO

• Adult Health Nurse Practitioner in Joplin, MO
• Providers in Joplin, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.