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KENNETH L DERRINGTON M.D.
NPI 1124023940
Family Medicine in Gravois Mills, MO

Active since June 17, 2005
156 MISSOURI BLVD STE B, GRAVOIS MILLS, MO 65037(573) 374-5263(573) 374-4933 Get Directions Write a Review

NPPES record last updated: March 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kenneth L Derrington M.d. NPPES

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

KENNETH L DERRINGTON M.D. (NPI 1124023940) is an individual family medicine provider in Gravois Mills, Missouri, licensed in Missouri (R9A11) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1124023940
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKENNETH L DERRINGTONCredential: M.D.
Location Address156 MISSOURI BLVD STE BGravois Mills, MO 65037-5394
Mailing AddressPo Box 1519Laurie, MO 65038-1519 · (573) 374-5800 · Fax (573) 374-5697
Phone(573) 374-5263
Fax(573) 374-4933
Sole ProprietorNo
Enumeration DateJune 17, 2005
Last NPPES UpdateMarch 19, 2018
✔ NPI 1124023940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · R9A11
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.
156 MISSOURI BLVD STE B, Gravois Mills, MO 65037
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Other Identifiers 2

Medicaid201366010MO
OtherR9A11MO · Mo License

Other Providers at the Same Location NPPES

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

KIMBERLY COLLINS ANP
Nurse Practitioner (Family)
156 MISSOURI BLVD STE B
GRAVOIS MILLS, MO 65037
Morgan County (573) 374-5263

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 Kenneth Derrington's NPI number?

The NPI number for Kenneth Derrington is 1124023940. It was assigned to this individual provider in the NPPES registry on June 17, 2005.

Where is Kenneth Derrington located?

Kenneth Derrington practices at 156 Missouri Blvd Ste B, Gravois Mills, MO 65037. The listed phone number is (573) 374-5263.

What is Kenneth Derrington's specialty?

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

When was this NPI record last updated?

The NPPES record for Kenneth Derrington was last updated on March 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.