Individual provider Active NPI

Megan Ann Derrer, MD

  • Neonatal-Perinatal Medicine Physician
  • Memphis, TN
National Provider Identifier
1942687801
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
64904 Issued in TN
Practice address
853 Jefferson Ave
Memphis, TN 38103-2804
Phone
(901) 448-5950
Fax
(901) 448-1691
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 69128-20 WI
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X 64904 TN Primary

Addresses

Primary practice location

853 Jefferson Ave
Memphis, TN 38103-2804

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 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

Enrollment IDStateProvider typePAC IDDetails
I20220609000056 TN Practitioner - Pediatric Medicine 4284949983 Reassigns benefits to 1 organization
I20260626004627 AR Practitioner - Pediatric Medicine 4284949983

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

225 E Washington Ave
Jonesboro, AR 72401-3111

6100 Waterford District Drive
Suite 450
Miami, FL 33126-4692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69128-20WIMDPediatrics Physician
64904TNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group Inc Neonatal-Perinatal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Ut Medical Group, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

853 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-4795

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

Interoperability endpoints

  • Direct secure messaging: mderrer30275@mlh.direct-ci.com
  • FHIR API: https://epicproxy.et1342.epichosted.com/APIProxyPRD/MLH/api/FHIR/R4

Organizations & group practices 3

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1942687801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032804",
            "telephone_number": "901-448-5950",
            "fax_number": "901-448-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRER",
        "first_name": "MEGAN",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "69128-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "64904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.