DERRICK J SANDERSON (NPI# 1043577448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043577448 |
| Entity Type | Individual |
| Full Name | DERRICK J SANDERSON |
| Practice Address |
4199 Gateway Blvd Ste 3500 Newburgh IN 47630-7909 |
| Practice Telephone | 8128585950 |
| Practice Fax Number | 8128585955 |
| Mailing Telephone | 8128585990 |
| Mailing Fax Number | 8128585955 |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 283330 | NY | Allopathic & Osteopathic Physicians |
| Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
02005887A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300038901 | 05 | |
| KY | 7100666260 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1540 Maple Rd, Williamsville, NY 142213647 | 7165683600 |
| Street Address |
4199 GATEWAY BLVD STE 3500 |
| City | NEWBURGH |
| State | IN |
| Zip Code | 47630-7909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104101047 | Amanda Jo Phelps | Nurse Practitioner | 4199 Gateway Blvd Ste 3500, Newburgh, IN 47630-7909 | 2011-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477199859 | Dana Marie Deken | Physical Therapy Assistant | 322 Bell Oaks, Newburgh, IN 47630 | 2019-11-21 |
| 1851948897 | Riley Elizabeth Eilken | Physical Therapist | 4233 Gateway Glbd, Suite 201, Newburgh, IN 47630 | 2019-08-23 |
| 1851851174 | Jennifer Ozete Cole | Physical Therapist | 4233 Gateway Boulvard Suite 201, Newburgh, IN 47630 | 2019-03-22 |
| 1174014542 | Katherine E Lyle | Music Therapist | 1003 Sr 662 W, Newburgh, IN 47630 | 2018-05-22 |
| 1144719923 | Jennifer Michelle Huffman | Occupational Therapy Assistant | 9800 Lincolne Avenue, Newburgh, IN 47630 | 2018-05-07 |
| 1215431846 | Deaconess Specialty Physicians, Inc | Internal Medicine | 4007 Gateway Blvd Ste 100, Newburgh, IN 47630 | 2018-03-20 |
| 1801313002 | Deaconess Hospital, Inc | Pharmacy | 4209 Gateway Blvd., Newburgh, IN 47630 | 2017-08-28 |
| 1629435599 | Caitlyn Beckinger | Physical Therapy Assistant | 9800 Lincoln Ave, Newburgh, IN 47630 | 2016-01-24 |
| 1568869410 | Jill Buck | Social Worker | 8788 Ruffian Ln Ste D, Newburgh, IN 47630 | 2014-11-20 |
| 1003191057 | Marshall Alan Cox | Pharmacist | 7769 Hwy 66, Newburgh, IN 47630 | 2011-10-20 |
| Find all providers in zip 47630 | ||||
| Taxonomy Code | 207VF0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487809588 | Associated Surgeons and Physicians, LLC | Obstetrics & Gynecology | 2518 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2008-11-18 |
| 1003880527 | Gita S Singh | Obstetrics & Gynecology | 2512 E Dupont Rd, Suite 100, Fort Wayne, IN 46825-1675 | 2006-02-13 |
| 1386639565 | Scott C Boyd | Obstetrics & Gynecology | 2518 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2005-09-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.