JAMES LYLE DERICKSON MD
NPI 1023035524
Family Medicine in Nogales, AZ

Q: What is James Derickson's NPI number?

The NPI number for James Derickson is 1023035524. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Q: What is James Derickson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for James Derickson was last updated on November 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 17, 2006

1852 N MASTICK WAY, NOGALES, AZ 85621(520) 281-1550(520) 281-4487 Get Directions Write a Review

NPPES record last updated: November 28, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 28, 2018, Mar 1, 2018, Jun 29, 2016 (3 updates tracked since 2016).

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About James Lyle Derickson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES LYLE DERICKSON MD (NPI 1023035524) is an individual family medicine provider in Nogales, Arizona, licensed in Arizona (37067) and active in the NPI registry since July 2006. He maintains a secondary practice location in Green Valley.

NPPES Registry Identity

NPI1023035524

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJAMES LYLE DERICKSONCredential: MD

Location Address1852 N MASTICK WAYNogales, AZ 85621

Mailing Address825 N Grand Ave Ste 100Nogales, AZ 85621-1061 · (520) 761-2133 · Fax (520) 281-2335

Phone(520) 281-1550

Fax(520) 281-4487

Sole ProprietorNo

Enumeration DateJuly 17, 2006

Last NPPES UpdateNovember 28, 20183 updates tracked since enumeration

✔ NPI 1023035524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AZ · 37067

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1852 N MASTICK WAY, Nogales, AZ 85621

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Secondary Practice Location 1

Location 11260 S Campbell Rd, Building 2Green Valley, AZ 85614-2666 · Phone (520) 407-5800 · Fax (520) 407-5990

Other Identifiers 1

Medicaid266946AZ

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIPOSA COMMUNITY HEALTH CENTER, INC

Radiology (Diagnostic Radiology)