ALIVIA RENEA DERHAM APN
NPI 1386142503
Nurse Practitioner in Galesburg, IL

Active since January 23, 2018PECOS EnrolledAccepts Medicare Assignment
3375 N SEMINARY ST, GALESBURG, IL 61401(309) 343-5114(309) 343-7859 Get Directions Write a Review

NPPES record last updated: January 23, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Alivia Renea Derham Apn NPPES

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

ALIVIA RENEA DERHAM APN (NPI 1386142503) is an individual nurse practitioner in Galesburg, Illinois, licensed in Illinois (209017147) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS, is affiliated with Graham Hospital Association, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1386142503
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameALIVIA RENEA DERHAMCredential: APN
Location Address3375 N SEMINARY STGalesburg, IL 61401-1251
Mailing Address3375 N Seminary StGalesburg, IL 61401-1251 · (309) 343-5114 · Fax (309) 343-7859
Fax(309) 343-7859
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 23, 2018
NPI 1386142503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in IL · 209017147
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3375 N SEMINARY ST, Galesburg, IL 61401

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

Alivia Renea Derham Apn 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 ID840550695
PECOS Enrollment IDI20180216000026
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
484 services44 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
96 services92 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
71 services62 patients
Injection, methylprednisolone acetate, 80 mg J1040
Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
27 services20 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Graham Hospital Association

Acute Care Hospitals · Canton, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140001
Location210 West Walnut StreetCanton, IL 61520 · Fulton County
Emergency services Birthing friendly

Mc Donough District Hospital

Acute Care Hospitals · Macomb, IL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number140089
Location525 East Grant StreetMacomb, IL 61455 · Mc Donough County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61401 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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.

Nutritionist
3375 N SEMINARY ST
GALESBURG, IL 61401
Family Medicine
3375 N SEMINARY ST
GALESBURG, IL 61401
Nurse Practitioner (Family)
3375 N SEMINARY ST
GALESBURG, IL 61401
Family Medicine
3375 N SEMINARY ST
GALESBURG, IL 61401
Nurse Practitioner
3375 N SEMINARY ST
GALESBURG, IL 61401
Nurse Practitioner
3375 N SEMINARY ST
GALESBURG, IL 61401
Family Medicine
3375 N SEMINARY ST
GALESBURG, IL 61401
Nurse Practitioner
3375 N SEMINARY ST
GALESBURG, IL 61401

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 Alivia Derham's NPI number?

The NPI number for Alivia Derham is 1386142503. It was assigned to this individual provider in the NPPES registry on January 23, 2018.

Where is Alivia Derham located?

Alivia Derham practices at 3375 N Seminary St, Galesburg, IL 61401. The listed phone number is (309) 343-5114.

What is Alivia Derham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Alivia Derham enrolled in Medicare?

Yes. Alivia Derham 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.

Is Alivia Derham affiliated with any hospitals?

According to CMS data, Alivia Derham is affiliated with Graham Hospital Association and Mc Donough District Hospital.

When was this NPI record last updated?

The NPPES record for Alivia Derham was last updated on January 23, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.