JOHN BURTON DERRICK
NPI 1932253606
Physician Assistant - Medical in Vidalia, GA

Active since January 22, 2007PECOS EnrolledAccepts Medicare Assignment
300 ARLINGTON DR, VIDALIA, GA 30474(912) 538-0830 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About John Burton Derrick NPPES

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

JOHN BURTON DERRICK (NPI 1932253606) is an individual medical provider in Vidalia, Georgia, licensed in Georgia (01655) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Memorial Health Meadows Hospital, and is a graduate of Medical University Of South Carolina College Of Medicine (1975).

NPPES Registry Identity

NPI1932253606
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJOHN BURTON DERRICK
Location Address300 ARLINGTON DRVidalia, GA 30474-0645
Mailing Address300 Arlington Dr, Po Box 645Vidalia, GA 30475 · (912) 538-0830
Sole ProprietorYes
Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 1975
Enumeration DateJanuary 22, 2007
Last NPPES UpdateMarch 7, 2023
NPI 1932253606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in GA · 01655
300 ARLINGTON DR, Vidalia, GA 30474

Other Identifiers 1

Other01655GA · License

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

John Burton Derrick 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 ID5597734129
PECOS Enrollment IDI20110113000620
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

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services23 patients

Hospital Affiliations CMS Care Compare

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

Memorial Health Meadows Hospital

Acute Care Hospitals · Vidalia, GA
5/5 CMS rating
OwnershipProprietary
CMS Certification Number110128
LocationOne Meadows ParkwayVidalia, GA 30474 · Toombs County
Emergency services

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
1 supplier11 claims11 services$106.58 avg. paid by Medicare
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823
DME-Wheelchairs · category DD009N
1 supplier13 claims13 services$174.35 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Community Health)
300 ARLINGTON DR
VIDALIA, GA 30474

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 John Derrick's NPI number?

The NPI number for John Derrick is 1932253606. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Where is John Derrick located?

John Derrick practices at 300 Arlington Dr, Vidalia, GA 30474. The listed phone number is (912) 538-0830.

What is John Derrick's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is John Derrick enrolled in Medicare?

Yes. John Derrick 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 John Derrick affiliated with any hospitals?

According to CMS data, John Derrick is affiliated with Memorial Health Meadows Hospital.

When was this NPI record last updated?

The NPPES record for John Derrick was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.