Individual provider Active NPI

Derrick Vander Linden, DC

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1932963899
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2183 Issued in NE
Practice address
302 N 168TH Cir Ste 208
Omaha, NE 68118-4089
Phone
(402) 889-6881
NPI assigned
Feb 12, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2183 NE Primary

Addresses

Primary practice location

302 N 168TH Cir Ste 208
Omaha, NE 68118-4089

Mailing address

596 Sandy Pointe PL
Ashland, NE 68003-7434
Phone (402) 889-6881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626001066 NE Practitioner - Chiropractic 5193269397

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagner Chiropractic Clinic PCGroup PAC ID 2264484047, 2 clinicians

Practice addresses (Care Compare)

2639 S 159TH PLZ
Omaha, NE 68130-1705
Phone (402) 334-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2183NEMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wagner Chiropractic Clinic, PC Chiropractor CurrentSince Mar 1, 2005 Accepting new patients

Locations

2639 S 159th Plz
Omaha, NE 68130
Phone (402) 334-4700

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1932963899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 SANDY POINTE PL",
            "city": "ASHLAND",
            "state": "NE",
            "postal_code": "680037434",
            "telephone_number": "402-889-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N 168TH CIR STE 208",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681184089",
            "telephone_number": "402-889-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER LINDEN",
        "first_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "2183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.