DR. KELLY JOSEPH DERRICK D.O. NPI 1407065725

Family Medicine in Irving, TX

NPI 1407065725 Individual Male Family Medicine PECOS Enrolled

NPI Profile for DR. KELLY JOSEPH DERRICK D.O.

Kelly Derrick is a primary care provider established in Irving, Texas and his medical specialization is family medicine. The NPI number of Kelly Derrick is 1407065725 and was assigned on May 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 5489 (OK). The provider is registered as an individual and his NPI record was last updated one year ago.

A primary care provider (PCP) like Dr. Kelly Joseph Derrick D.o. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Kelly Derrick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices..

Kelly Derrick is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1407065725

Provider NameDR. KELLY JOSEPH DERRICK D.O.
Provider Location Address6363 N STATE HIGHWAY 161 STE 100 IRVING, TX 75038
Provider Mailing Address1223 W MAIN ST #1241 DURANT, OK 74701
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date05-22-2007
Last Update Date09-09-2021


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.5489
License StateOK
Taxonomy DescriptionFamily 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.

Business Address

DR. KELLY JOSEPH DERRICK D.O.
6363 N STATE HIGHWAY 161 STE 100
IRVING, TX
ZIP 75038
Phone: (469) 200-3272

Get Directions


Mailing Address

DR. KELLY JOSEPH DERRICK D.O.
1223 W MAIN ST
#1241
DURANT, OK
ZIP 74701
Phone: (870) 273-5945



Secondary Locations

2901 Medical Center Dr
Pocahontas, AR 72455
(870) 892-4468

PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineE-5244ARNo

Taxonomy Description: 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.

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1407065725
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2407061074
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 0 + 7 + 0 + 6 + 1 + 0 + 7 + 4 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1407065725 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1609198936 YONAH KNUCKLES NP
Individual
Nurse Practitioner (Adult Health)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1831654128MRS. HEATHER R SANDS RN
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1457829640 OBUCHUKWUNEME UGHANZE CALAIS FNP
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1952820227 YUN HEE BAEK FNP
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1033648837 ADAM C BROCK FNP
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1932458254 FRANCES J WELLER APRN
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1649824509 LAWRENCE IDIGBE
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1235371030 TAPAN RAJARSHI MEHTA MD
Individual
Internal Medicine6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1053762559 VERA AGBIGBE
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1730643511MS. THERNESSIA LASHON BOWE PMHNP-BC
Individual
Nurse Practitioner (Psychiatric/Mental Health)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1265980544 CHRISTINA HERNANDEZ FNP
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1154701746MRS. NKEIRU P ANYANWU NP
Individual
Nurse Practitioner (Gerontology)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1811470982 DEBORAH KERNER FNP-C
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1730479668 ZENOBIA L NEWMAN FNP-BC
Individual
Nurse Practitioner6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1861932931 KASIRIM MASI
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1770995649 CAROLYN JANE BOGAN FNP-BC
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1437530862 ROYA KHODAIE
Individual
Internal Medicine6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1780257832MR. TOKPAH O MILLER SR. FNP-C
Individual
Nurse Practitioner (Adult Health)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1740697770 LAURA RANGIRA
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272
1003435843 JILLY JOHN
Individual
Nurse Practitioner (Family)6363 N STATE HIGHWAY 161 STE 100
IRVING, TX 75038
(469) 200-3272

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Kelly Joseph Derrick D.o. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.