ROSETTA ANN DERRICK (NPI# 1396219390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396219390 |
| Entity Type | Individual |
| Full Name | ROSETTA ANN DERRICK |
| Credential | NP |
| Practice Address |
2258 Wrightsboro Rd Augusta GA 30904-4887 |
| Mailing Address |
850 Ben Franklin Rd Gilbert SC 29054-9520 |
| Practice Telephone | 7067244400 |
| Practice Fax Number | 7067246003 |
| Mailing Telephone | 8032604250 |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN241900 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2258 WRIGHTSBORO RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793253 | Asa Daniel Duggan Jr. | Surgery | 2258 Wrightsboro Rd, Augusta, GA 30904-4887 | 2005-07-11 |
| 1144690033 | Riverside Anesthesia | Nurse Anesthetist, Certified Registered | 2258 Wrightsboro Rd, Augusta, GA 30904-4887 | 2015-10-05 |
| 1366811036 | Melonie Taylor Mcbride | Physical Therapist | 2258 Wrightsboro Rd, Suite 250, Augusta, GA 30904-4887 | 2015-09-23 |
| 1811365596 | Maguire Therapy Services | Massage Therapist | 2258 Wrightsboro Rd, Augusta, GA 30904-4887 | 2015-09-11 |
| 1881060879 | Giovanna Mustin | Occupational Therapy Assistant | 2258 Wrightsboro Rd, Augusta, GA 30904-4887 | 2015-08-13 |
| 1578948782 | Maguire Therapy Services,inc. | Occupational Therapy Assistant | 2258 Wrightsboro Rd, Suite 250, Augusta, GA 30904-4887 | 2015-07-29 |
| 1679960561 | Christina Samar Khal | Occupational Therapist | 2258 Wrightsboro Rd, Suite 250, Augusta, GA 30904-4887 | 2015-04-20 |
| 1346688058 | Niti Bhalla Carlson Md PC | Obstetrics & Gynecology | 2258 Wrightsboro Rd, Suite 200, Augusta, GA 30904-4887 | 2013-06-05 |
| 1710249966 | Gary Williamson, M.d., P.C. | Plastic Surgery | 2258 Wrightsboro Rd, Suite 180, Augusta, GA 30904-4887 | 2012-06-13 |
| 1093007890 | Bie Mende Etinge | Internal Medicine | 2258 Wrightsboro Rd, Suite 300, Augusta, GA 30904-4788 | 2011-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1588262372 | Taylor Safford | Nurse Practitioner | 1348 Walton Way Ste 4100, Augusta, GA 30901-5107 | 2020-10-13 |
| 1831719269 | Tanaysa Green | Nurse Practitioner | 1702 Holly Hill Rd, Augusta, GA 30904-5050 | 2020-04-27 |
| 1699395749 | Mary Elizabeth Dalis | Nurse Practitioner | 1025 Redbird Rd, Augusta, GA 30904-3181 | 2020-04-18 |
| 1316585185 | Rebecca Williford | Nurse Practitioner | 1220 George C Wilson Dr, Augusta, GA 30909-4501 | 2019-12-12 |
| 1699322370 | Ashley Staten | Nurse Practitioner | 2739 Huntcliffe Dr, Augusta, GA 30909-0662 | 2019-08-19 |
| 1053978205 | Keneka V Allen | Nurse Practitioner | 6229 Key West Dr, Augusta, GA 30909-6745 | 2019-05-23 |
| 1487210589 | Jason Schunk | Nurse Practitioner | S7645 Morning Crest Dr, Augusta, WI 54722-7579 | 2019-05-14 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1174097190 | Yuri Kang | Nurse Practitioner | Augusta University Medical Center 1120 15th Street, Augusta, GA 30912-0359 | 2019-01-12 |
| Find all providers in AUGUSTA | ||||
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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.