DR. DERECK DAVIS
NPI 1174567580
Pediatrics in Jackson, MS

Active since June 15, 2006PECOS EnrolledAccepts Medicare Assignment
69.83/100
CMS Quality Rating
2600 N STATE ST, JACKSON, MS 39216(601) 984-5220(601) 984-5279 Get Directions Write a Review

NPPES record last updated: August 11, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Dereck Davis NPPES

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

DR. DERECK DAVIS (NPI 1174567580) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (18418) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of South Alabama College Of Medicine (2001).

NPPES Registry Identity

NPI1174567580
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. DERECK DAVIS
Location Address2600 N STATE STJackson, MS 39216-4301
Mailing Address2600 N State StJackson, MS 39216-4301 · (601) 984-5220 · Fax (601) 984-5279
Fax(601) 984-5279
Sole ProprietorNo
Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 2001
Enumeration DateJune 15, 2006
Last NPPES UpdateAugust 11, 2014
NPI 1174567580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses Licensed in MS · 18418 Licensed in NC · 2007-00180
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2600 N STATE ST, Jackson, MS 39216

Other Identifiers 3

Medicare OSCAR/certification302I378946MS
Medicare UPINI16185MS
Medicaid02170804MS

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Dereck Davis 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 ID7810965167
PECOS Enrollment IDI20040923000734
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

69.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.08
Promoting Interoperability83
Improvement Activities40
Cost48.31

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174567580, enumerated as an "individual" on June 15, 2006.

The provider is located at 2600 N STATE ST JACKSON, MS 39216 and the phone number is (601) 984-5220.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.