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VICKI DERRY
NPI 1053574418
Counselor in Bellingham, WA

Active since July 07, 2008PECOS EnrolledAccepts Medicare Assignment
2592 KWINA RD, BELLINGHAM, WA 98226(360) 384-0464 Get Directions Write a Review

NPPES record last updated: July 7, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Vicki Derry NPPES

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

VICKI DERRY (NPI 1053574418) is an individual counselor in Bellingham, Washington, licensed in Washington (RC00022403) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1053574418
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameVICKI DERRY
Location Address2592 KWINA RDBellingham, WA 98226-9278
Mailing Address2592 Kwina RdBellingham, WA 98226-9278 · (360) 384-0464
Phone(360) 384-0464
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 7, 2008
✔ NPI 1053574418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in WA · RC00022403
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
2592 KWINA RD, Bellingham, WA 98226
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vicki Derry is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597921650
PECOS Enrollment IDI20220304000702
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Vicki Derry reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lummi Indian Business Council
0.1 mi
Counselor
2608 KWINA RD
Bellingham, WA 98226
  • Reassigned Medicare billing, Texas and Washington enrollments
  • Also billed through NPI 1669592374 (Washington)
  • 11 clinicians in this Medicare group
NPI 1225158769 (360) 312-2019
Kaw Nation
1,527 mi
Clinic/Center
3151 E. RIVER ROAD
Newkirk, OK 74647
  • Reassigned Medicare billing, Texas enrollment
  • 8 clinicians in this Medicare group
NPI 1487752465 (580) 362-1039

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. DALE HAVEMAN M.D
Pediatrics
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 384-0464
MARY M VARCO RN
Registered Nurse
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 384-0464
MICHELLE O'BRIEN RN
Registered Nurse
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 312-2000
TODD BOSS RPH
Pharmacist
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 312-2476
ROBERT DESMOND ARNP
Registered Nurse (Pediatrics)
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 384-0464
PENNY MILCZEWSKI
Counselor (Mental Health)
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 384-0464
KATIE MARIE GOGER LICSW
Social Worker (Clinical)
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 312-2000
MICHAEL JONATHAN PHILLIPS-JIMMY CPC
Peer Specialist
2592 KWINA RD
BELLINGHAM, WA 98226
Whatcom County (360) 312-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vicki Derry's NPI number?

The NPI number for Vicki Derry is 1053574418. It was assigned to this individual provider in the NPPES registry on July 7, 2008.

Where is Vicki Derry located?

Vicki Derry practices at 2592 Kwina Rd, Bellingham, WA 98226. The listed phone number is (360) 384-0464.

What is Vicki Derry's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Vicki Derry enrolled in Medicare?

Yes. Vicki Derry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Vicki Derry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vicki Derry reassigns Medicare benefits to 2 organizations: Lummi Indian Business Council (Bellingham, WA) and Kaw Nation (Newkirk, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vicki Derry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vicki Derry was last updated on July 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.