DERRICK ALWYN FOX (NPI# 1336403237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336403237 |
| Entity Type | Individual |
| Full Name | DERRICK ALWYN FOX |
| Credential | M.D. |
| Practice Address |
1701 E College Ave Bloomington IL 61704-2101 |
| Practice Telephone | 3096615050 |
| Practice Fax Number | 3094542434 |
| Mailing Telephone | 3096615050 |
| Mailing Fax Number | 3094542434 |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2019-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036150058 | IL | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MTL003086 | DC | Allopathic & Osteopathic Physicians |
| Street Address |
1701 E COLLEGE AVE |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982602140 | Brandy Lynn Redman | Occupational Therapist | 1701 E College Ave, Bloomington, IL 61704-2101 | 2005-07-12 |
| 1336777515 | Paula Roberts | Nurse Practitioner | 1701 E College Ave, Bloomington, IL 61704-2101 | 2020-04-01 |
| 1689150948 | Barbara Luann Weis | Psychiatry & Neurology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2018-07-18 |
| 1366949224 | Kayla Marie Hnilicka | Registered Nurse | 1701 E College Ave, Bloomington, IL 61704-2101 | 2018-04-09 |
| 1992227052 | Christine C Gardner | Nurse Practitioner | 1701 E College Ave, Bloomington, IL 61704-2101 | 2017-07-11 |
| 1033652243 | Sonal Mukesh Patel | Nurse Practitioner | 1701 E College Ave, Bloomington, IL 61704-2101 | 2016-11-21 |
| 1285013029 | Andrew Tharp | Nurse Practitioner | 1701 E College Ave, Bloomington, IL 61704-2101 | 2015-05-27 |
| 1154670073 | Amy Lynn Nelson | Occupational Therapist | 1701 E College Ave, Bloomington, IL 61704-2101 | 2012-09-06 |
| 1437434982 | Abbi Carr | Nurse Practitioner | 1701 E College Ave, Bloomington, IL 61704-2101 | 2011-10-17 |
| 1124311345 | Rachel Wayne | Dietitian, Registered | 1701 E College Ave, Bloomington, IL 61704-2101 | 2011-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083848550 | David W Harvey | Psychiatry & Neurology | 321 S Landmark Ave, Bloomington, IN 47403-5001 | 2009-05-12 |
| 1568667772 | Edward W Pegg Md, LLC | Psychiatry & Neurology | 1505 Eastland Dr Ste 2400, Bloomington, IL 61701-7911 | 2007-06-18 |
| 1245248293 | Jameson Daniel Way | Psychiatry & Neurology | 2315 E 3rd St, Bloomington, IN 47401-5320 | 2006-08-04 |
| 1760431712 | Mclean County Neurology Sc | Psychiatry & Neurology | 2204 Eastland Dr, Bloomington, IL 61704-3566 | 2006-05-08 |
| 1689150948 | Barbara Luann Weis | Psychiatry & Neurology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2018-07-18 |
| 1770038069 | Supriya Kairamkonda | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2016-08-17 |
| 1477875938 | Mehyar Mehrizi | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2010-02-24 |
| 1326233271 | Barry Jay Riskin | Psychiatry & Neurology | 2502 E Empire St, Bloomington, IL 61704-3738 | 2007-09-12 |
| 1194865642 | Neurology Specialists, PC | Psychiatry & Neurology | 813 W 2nd St, Bloomington, IN 47403-2212 | 2007-02-07 |
| 1043392160 | Edward W Pegg IIi | Psychiatry & Neurology | 1505 Eastland Dr, Suite 2400, Bloomington, IL 61701-3534 | 2006-10-19 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
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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.