DERRELL D DELOACH (NPI# 1548284433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548284433 |
| Entity Type | Individual |
| Full Name | DERRELL D DELOACH |
| Credential | FNP-C |
| Practice Address |
1500 S Coulter St Suite 6 Amarillo TX 79106-1791 |
| Practice Telephone | 8064679777 |
| Practice Fax Number | 8064679799 |
| Mailing Telephone | 8064679777 |
| Mailing Fax Number | 8064679799 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
604578 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 145651901 | 05 | |
| TX | PALMETTO DMERC | 1186100001 | 01 |
| TX | WORKER'S COMPENSATION | 604578 | 01 |
| TX | RAILRAOD MEDICARE | P00166964 | 01 |
| Street Address |
1500 S COULTER ST SUITE 6 |
| City | AMARILLO |
| State | TX |
| Zip Code | 79106-1791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104844950 | Kimberly Anglin | Nurse Practitioner | 1500 S Coulter St, Amarillo, TX 79106-1791 | 2006-07-18 |
| 1548621758 | Joni Michelle Tversky | Nurse Practitioner | 1500 S Coulter St, Suite #6, Amarillo, TX 79106-1791 | 2016-03-15 |
| 1992106181 | Jamie Dodson | Nurse Practitioner | 1500 S Coulter St, Suite 6, Amarillo, TX 79106-1791 | 2014-09-08 |
| 1811322167 | Lindsaye Brooke Patterson | Nurse Practitioner | 1500 S Coulter St, # 6, Amarillo, TX 79106-1791 | 2013-09-05 |
| 1992014609 | Barbara L Jensen | Nurse Practitioner | 1500 S Coulter St, Suite 6, Amarillo, TX 79106-1791 | 2010-09-29 |
| 1144330762 | Sang Tae C Kim | Family Medicine | 1500 S Coulter St, Suite 6, Amarillo, TX 79106-1791 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773205 | Nisha Patel | Pharmacist | 1600 S Western Street, Amarillo, TX 79106 | 2020-09-01 |
| 1043851769 | Diana Moore | Pharmacist | 6010 Amarillo Blvd W (119), Amarillo, TX 79106 | 2019-10-03 |
| 1164988127 | Wade Family Services Pllc | Counselor | 1901 Medi Park Dr Suite 130, Amarillo, TX 79106 | 2019-02-14 |
| 1255802963 | Jennifer Cockrum | Hospitalist | Bsa Hospitalist, 1600 Wallace Blvd., Amarillo, TX 79106 | 2018-12-07 |
| 1346736691 | Denise Mills Donnell | Social Worker | 6010 Amarillo Bouldevard West Clc-b, Amarillo, TX 79106 | 2018-07-10 |
| 1124525472 | Abigail Batson | Student in an Organized Health Care Education/Training Program | 1400 S Coulter Street, Suite 1500, Amarillo, TX 79106 | 2018-04-11 |
| 1053812743 | Moc Amarillo, LLC | Skilled Nursing Facility | 1540 Research St., Amarillo, TX 79106 | 2018-02-27 |
| 1013459437 | Larry G. Schulz | Durable Medical Equipment & Medical Supplies | 1901 Medi Park Dr Ste 219, Amarillo, TX 79106 | 2016-11-16 |
| 1922453315 | Omar Saeed M Alzhrani | Student in an Organized Health Care Education/Training Program | 1400 S. Coulter - Suite 5100, Amarillo, TX 79106 | 2016-05-04 |
| 1972967529 | David Wayne Hohon | Internal Medicine | Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 | 2016-04-11 |
| Find all providers in zip 79106 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083229629 | Donna Jeannette Mccauley | Nurse Practitioner | 7407 Imperial Dr, Amarillo, TX 79121-1429 | 2020-09-10 |
| 1902414998 | Sarah Jane Fisk | Nurse Practitioner | 1901 Medi Park Dr Ste 103, Amarillo, TX 79106-2106 | 2020-07-16 |
| 1801410063 | Jeannette Sandoval | Nurse Practitioner | 2329 Ross Osage, Amarillo, TX 79103-3000 | 2020-06-03 |
| 1962044941 | Donna Raef Kizziar | Nurse Practitioner | Bsa Urgent Care Clinic, 4510 Bell St., Amarillo, TX 79109 | 2019-10-11 |
| 1225679400 | Wendy Dawn Guest | Nurse Practitioner | 7716 Pinnacle Dr, Amarillo, TX 79119-7494 | 2019-09-30 |
| 1326609835 | Chelsea Beth Stevens | Nurse Practitioner | 609 S Carolina St, Amarillo, TX 79106-8721 | 2019-06-25 |
| 1184187759 | Lauren Altendorf | Nurse Practitioner | 3501 S Soncy Rd Ste 110, Amarillo, TX 79119-6405 | 2019-04-10 |
| 1851853311 | Sandra Renee Morris Boyd | Nurse Practitioner | 20001 Wind River Dr, Amarillo, TX 79124-1682 | 2019-04-03 |
| 1245795780 | Monica Favela Prieto | Nurse Practitioner | Bsa Urgent Care Clinc, 4510 Bell St., Amarillo, TX 79109 | 2019-02-08 |
| 1609349042 | Sarah Price | Nurse Practitioner | 5109 Navajo Trl, Amarillo, TX 79110-4635 | 2019-01-08 |
| Find all providers in AMARILLO | ||||
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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.