Individual provider Active NPI

Derek Allen Lawhorn

  • Nurse Practitioner
  • Waverly, OH
National Provider Identifier
1952932642
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.026256 Issued in OH
Practice address
835 W Emmitt Ave
Waverly, OH 45690-1190
Phone
(740) 947-7662
Fax
(740) 941-0099
NPI assigned
Jan 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.026256 OH Primary

Addresses

Primary practice location

835 W Emmitt Ave
Waverly, OH 45690-1190

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-7942

Other identifiers 1

IdentifierTypeStateIssuer
0393205MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derek.lawhorn@somc.medicity.net

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210430002096 OH Practitioner - Nurse Practitioner 2567871684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8117

835 W Emmitt Ave
Waverly, OH 45690-1190
Phone (740) 947-7662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.026256OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. CurrentSince Mar 30, 2021 Accepting new patients
Somc Medical Care Foundation, Inc. Nurse Practitioner CurrentSince Mar 30, 2021 Accepting new patients

Locations

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

835 W Emmitt Ave
Waverly, OH 45690
Phone (740) 356-5944

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1952932642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-7942",
            "fax_number": "740-356-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 W EMMITT AVE",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901190",
            "telephone_number": "740-947-7662",
            "fax_number": "740-941-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWHORN",
        "first_name": "DEREK",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.026256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0393205",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derek.lawhorn@somc.medicity.net",
            "affiliation": "N",
            "address_1": "835 W Emmitt Ave",
            "city": "Waverly",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456901190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

Verify at the official NPI Registry.