Derrick T Dube, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8720 Issued in AZ

Practice address

8016 State Line Rd
Ste 100
Prairie Village, KS 66208-3721

Phone

(913) 826-6837

Fax

(913) 341-4301

NPI assigned

May 9, 2016

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1982050993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 S VAL VISTA DR",
            "address_2": "STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951693",
            "telephone_number": "602-592-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8016 STATE LINE RD",
            "address_2": "STE 100",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662083721",
            "telephone_number": "913-826-6837",
            "fax_number": "913-341-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "DERRICK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX IDENTIFICATION NUMBER",
            "identifier": "81-2039071",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "01-05796",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EIN",
            "identifier": "8247108",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James L Donley, M.D.
• Margaret G Donley, MSW
• Barbara A Dooley
• Valerie Downs
• Jenna Drake
• Jaime McGinnis Duke, LPC
• Seth Dunham, LPC
• Olivia Ann Dunsmore, OTR/L
• Madeleine Dusselier, DNP, APRN, AGACNP-BC
• Jessica M Duvall, DPT

• Chiropractor in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.