DEREK WAKEFIELD DO
NPI 1164124541
Student in an Organized Health Care Education/Training Program in Jackson, TN

Q: What is Derek Wakefield's NPI number?

The NPI number for Derek Wakefield is 1164124541. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Derek Wakefield's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Wakefield was last updated on March 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 20, 2023PECOS Enrolled

294 SUMMAR DR, JACKSON, TN 38301(731) 423-1932(731) 660-8739 Get Directions Write a Review

NPPES record last updated: March 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Derek Wakefield Do NPPES

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

DEREK WAKEFIELD DO (NPI 1164124541) is an individual student in an organized health care education/training program in Jackson, Tennessee and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164124541

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDEREK WAKEFIELDCredential: DO

Location Address294 SUMMAR DRJackson, TN 38301-3915

Mailing Address294 Summar DrJackson, TN 38301-3915 · (731) 423-1932 · Fax (731) 660-8739

Phone(731) 423-1932

Fax(731) 660-8739

Sole ProprietorNo

Enumeration DateMarch 20, 2023

NPPES CertifiedMarch 20, 2023

✔ NPI 1164124541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

294 SUMMAR DR, Jackson, TN 38301

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Wakefield Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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