JEFFREY DAVID DERRY LPC
NPI 1528359734
Counselor - Professional in Fountain, CO
About Jeffrey David Derry Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEFFREY DAVID DERRY LPC (NPI 1528359734) is an individual professional provider in Fountain, Colorado, licensed in Colorado (LPC.0003637) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lake Ozark, and is a graduate of Other (1999).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jeffrey David Derry Lpc 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.
Medicare Billing Reassignment
Medicare enrollment records show Jeffrey Derry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Colorado Springs, CO 80917
- Reassigned Medicare billing, Colorado enrollment
- 355 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jeffrey Derry's NPI number?
The NPI number for Jeffrey Derry is 1528359734. It was assigned to this individual provider in the NPPES registry on April 21, 2011.
Where is Jeffrey Derry located?
Jeffrey Derry practices at 350 Lyckman Pl, Fountain, CO 80817. The listed phone number is (719) 632-5700.
What is Jeffrey Derry's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jeffrey Derry enrolled in Medicare?
Yes. Jeffrey Derry 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.
Which organization bills Medicare for Jeffrey Derry's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Derry reassigns Medicare benefits to Peak Vista Community Health Centers (Colorado Springs, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffrey Derry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jeffrey Derry accept?
Health plans from Oscar Insurance Company and Select Health list Jeffrey Derry as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jeffrey Derry was last updated on March 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jeffrey David Derry, LPC · NPI 1528359734
Professional provider in Fountain, Colorado. Individual provider, active in the CMS NPPES registry since April 21, 2011.
## Identity
- **NPI:** 1528359734 (Entity type: Individual)
- **Enumerated:** April 21, 2011
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC.0003637 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 350 LYCKMAN PL, Fountain, CO 80817-2861
- **Phone:** (719) 632-5700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Peak Vista Community Health Centers (NPI 1730166034, Colorado Springs, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1999
## Record status
- **NPPES last updated:** March 21, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1528359734) · Data from the CMS NPPES public registry.