Derick Lee Tibbetts, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

638 S Whittier St
Wichita, KS 67207-2222

Phone

(316) 841-3810

NPI assigned

Feb 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1972800514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 S WHITTIER ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672072222",
            "telephone_number": "316-841-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 S WHITTIER ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672072222",
            "telephone_number": "316-841-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "DERICK",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Thurman Tayrien
• Amy Nicole Thurman, LPC
• THVC Services of KS PA
• Bonnie Cassidy Tibbe, MD
• Joshua Tibbe, MD
• Stephanie Nicol Tice, CRNA
• Olivia S Tickles
• Rachelle Tiffany, PA
• Wendi L Tilson, P.A.
• Tilt Therapy LLC

• Independent Duty Medical Technicians in Wichita, KS
• Providers in Wichita, KS by specialty
• Independent Duty Medical Technicians in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.