John Deryl Adderson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A34404 Issued in CA

Practice address

6106 Regents Rd
San Diego, CA 92122-2245

Phone

(858) 625-2466

Fax

(858) 625-2041

NPI assigned

Jun 7, 2006

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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 1

Specialty

Family Practice

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jadderson34565@sharphealthcare.direct-ci.com
• Direct secure messaging: johnadderson@addjo.allscriptsdirect.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.

• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)

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

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation
• Sharp Coronado Hospital and Healthcare Center

  dba Sharp Coronado Hospital

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  Care Compare affiliation
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1932149069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6106 REGENTS RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222245",
            "telephone_number": "858-625-2466",
            "fax_number": "858-625-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6106 REGENTS RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222245",
            "telephone_number": "858-625-2466",
            "fax_number": "858-625-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDERSON",
        "first_name": "JOHN",
        "middle_name": "DERYL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A34404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnadderson@addjo.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6106 Regents Rd",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921222245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Perisha Adapa, RPH
• Adaptive Roots
• Dominick Addario, M.D.
• Kheriya Adde
• Mustaf Sufi Adde
• Addie's Autism Fitt
• Addie's Autismfitt Club
• Addie's Studio One on One, Inc. (Autism Fitt Club)
• Katherine Marie Addis, DPT
• Tiffany Addison

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.