Individual provider Active NPI

Shawn Derby

  • Nurse Practitioner
  • Great Falls, MT
National Provider Identifier
1972390649
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NUR-APRN-LIC-266796 Issued in MT
Practice address
1101 26TH St S
Great Falls, MT 59405-5161
Phone
(406) 455-5200
NPI assigned
Apr 24, 2025
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-69776 MT
Nurse Practitioner 363L00000X NUR-APRN-LIC-266796 MT Primary

Addresses

Primary practice location

1101 26TH St S
Great Falls, MT 59405-5161

Mailing address

PO Box 6010
Great Falls, MT 59406-6010
Phone (406) 455-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20250923003539 MT Practitioner - Nurse Practitioner 4385149152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN-69776MTMDRegistered Nurse
NUR-APRN-LIC-266796MTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc CurrentSince Sep 8, 2025 Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

Interoperability endpoints

  • Direct secure messaging: sderby18751@benefishs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1972390649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6010",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066010",
            "telephone_number": "406-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-455-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "RN-69776",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "NUR-APRN-LIC-266796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.