Active NPI
Judean Elizabeth Derby
- Counselor
- Antlers, OK
National Provider Identifier
1992024954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 204 SE a St
Pob 615
Antlers, OK 74523-4021 - Phone
- (580) 239-9354
- NPI assigned
- May 28, 2010
- Last updated
- May 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Social Worker | 104100000X |
Addresses
Primary practice location
204 SE a St
Pob 615
Antlers, OK 74523-4021
Mailing address
PO Box 615
204 SE a
Antlers, OK 74523-0615
Phone (580) 239-9354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275004800000",
"number": "1992024954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 615",
"address_2": "204 SE A",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745230615",
"telephone_number": "580-239-9354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 SE A ST",
"address_2": "POB 615",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745234021",
"telephone_number": "580-239-9354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBY",
"first_name": "JUDEAN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2010-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antlers, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.