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MS. KENWYN MAEVE DERBY
NPI 1700495652
Social Worker - Clinical in West Valley City, UT

Active since July 27, 2020PECOS EnrolledAccepts Medicare Assignment
2655 S LAKE ERIE DR, WEST VALLEY CITY, UT 84120(801) 441-4900 Get Directions Write a Review

NPPES record last updated: July 27, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Kenwyn Maeve Derby NPPES

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

MS. KENWYN MAEVE DERBY (NPI 1700495652) is an individual clinical provider in West Valley City, Utah and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1700495652
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. KENWYN MAEVE DERBY
Location Address2655 S LAKE ERIE DRWest Valley City, UT 84120-7350
Mailing Address882 E Millbrook WayBountiful, UT 84010-2053 · (415) 819-5530
Phone(801) 441-4900
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 27, 2020
NPPES CertifiedJuly 27, 2020
✔ NPI 1700495652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2655 S LAKE ERIE DR, West Valley City, UT 84120
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.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

Ms. Kenwyn Maeve Derby 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 ID547756041
PECOS Enrollment IDI20260105003154
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.

Medicare Billing Reassignment

Medicare enrollment records show Kenwyn Derby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Project Connection Utah LLC
Same address
Mental Health (Including Community Mental Health Center)
2655 S LAKE ERIE DR STE B
West Valley City, UT 84120
  • Reassigned Medicare billing, Utah enrollment
  • 11 clinicians in this Medicare group
NPI 1366330656 (385) 441-4900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84120 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
$0.00 typical visit price
range $54.34 – $166.03
Typical copayment $0.00 (range $13.58 – $41.50)
Most-billed visit code NA
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
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.

COURTNEY VANDERMYDEN
Counselor (Mental Health)
2655 S LAKE ERIE DR
WEST VALLEY, UT 84120
Salt Lake County (385) 441-4900
JESSIE MARIAH BAIRD
Counselor (Mental Health)
2655 S LAKE ERIE DR
WEST VALLEY, UT 84120
Salt Lake County (385) 441-4900
ROMAN FOX-NIKOLAEV
Community Health Worker
2655 S LAKE ERIE DR
WEST VALLEY CITY, UT 84120
Salt Lake County (385) 441-4900
KADE DANIEL ALLEN
Respite Care
2655 S LAKE ERIE DR
WEST VALLEY, UT 84120
Salt Lake County (385) 441-4900
MANNON CHRISTIANSON
Social Worker (Clinical)
2655 S LAKE ERIE DR
WEST VALLEY CITY, UT 84120
Salt Lake County (385) 441-4900
ROBERT EWING
Counselor (Mental Health)
2655 S LAKE ERIE DR
WEST VALLEY CITY, UT 84120
Salt Lake County (952) 913-9124
SKYLAR CHRISTINE GAMBLE
Social Worker (Clinical)
2655 S LAKE ERIE DR
WEST VALLEY, UT 84120
Salt Lake County (138) 544-1490
ANNALISA GREGORY CSW
Social Worker (Clinical)
2655 S LAKE ERIE DR
WEST VALLEY CITY, UT 84120
Salt Lake County (385) 321-5516

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 Kenwyn Derby's NPI number?

The NPI number for Kenwyn Derby is 1700495652. It was assigned to this individual provider in the NPPES registry on July 27, 2020.

Where is Kenwyn Derby located?

Kenwyn Derby practices at 2655 S Lake Erie Dr, West Valley City, UT 84120. The listed phone number is (801) 441-4900.

What is Kenwyn Derby's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kenwyn Derby enrolled in Medicare?

Yes. Kenwyn Derby 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 Kenwyn Derby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenwyn Derby reassigns Medicare benefits to Project Connection Utah LLC (West Valley City, UT). 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 Kenwyn Derby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenwyn Derby accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Kenwyn Derby 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 Kenwyn Derby was last updated on July 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.