MR. DERRICK R EDDY (NPI# 1720309511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720309511 |
| Entity Type | Individual |
| Full Name | MR. DERRICK R EDDY |
| Credential | CRNA |
| Practice Address |
2710 Rife Medical Ln Rogers AR 72758-1452 |
| Mailing Address |
Po Box 507 Lowell AR 72745-0507 |
| Practice Telephone | 9136424900 |
| Practice Fax Number | 9133810979 |
| Mailing Telephone | 9136424900 |
| Mailing Fax Number | 9133810979 |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2017-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | C002970 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 198801001 | 05 | |
| AR | TRICARE SOUTH | 1720309511 | 01 |
| MO | 1720309511 | 05 | |
| OK | 200494180A | 05 |
| Street Address |
2710 RIFE MEDICAL LN |
| City | ROGERS |
| State | AR |
| Zip Code | 72758-1452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265409585 | Donald S. Willig | Radiology | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2006-03-06 |
| 1235571456 | Allison Elizabeth Lee Mckay | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2013-07-30 |
| 1467896613 | Mercy Hospital Northwest Arkansas | Psychiatric Unit | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2013-04-18 |
| 1073873352 | Southeastern Emergency Services PC | General Acute Care Hospital | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2012-05-21 |
| 1760754725 | Regency Hospital of Northwest Arkansas, LLC | Hospitalist | 2710 Rife Medical Ln, 7th Floor, Rogers, AR 72758-1452 | 2012-02-06 |
| 1457620478 | Coleman Trey Thrash | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2011-12-20 |
| 1023312782 | Matthew W Shelby | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Anesthesia Dept, Rogers, AR 72758-1452 | 2011-01-10 |
| 1699076737 | Mercy Health Northwest Arkansas Communities | Pediatrics | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2010-11-05 |
| 1396077137 | Carie Olevia Landrum | Nurse Practitioner | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2010-02-04 |
| 1699004648 | Gabriel Chad Underwood | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Anesthesia Department, Rogers, AR 72758-1452 | 2009-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417588690 | Premier Hospitalists of Nwa, Pllc | Hospitalist | 4313 S Pleasant Crossing Blvd, Rogers, AR 72758 | 2020-01-28 |
| 1447893235 | Kelsey Elizabeth Sutton | Speech-Language Pathologist | 2100 West Perry Rd, Rogers, AR 72758 | 2019-10-24 |
| 1447700299 | Shannon Kaima | Physician Assistant | 5900 W Stoney Brook Rd Apt 14207, Rogers, AR 72758 | 2016-10-05 |
| 1801345426 | The Exclusive Eye, Pllc | Optometrist | 5100 W Pauline Whitaker Parkway, 107, Rogers, AR 72758 | 2016-09-23 |
| 1780063909 | Nicholas Honea | Nurse Anesthetist, Certified Registered | 4600 Centre Court, Rogers, AR 72758 | 2015-05-20 |
| 1811388945 | Amanda M Hawes | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2015-02-11 |
| 1316354087 | Natalie Horine | Chiropractor | 4305 S Pleasant Crossing Blvd Ste 102, Rogers, AR 72758 | 2014-07-15 |
| 1205248903 | Clyde K. Tempel | Registered Nurse | 2100 W. New Hope Rd. #1804, Rogers, AR 72758 | 2014-05-29 |
| 1548692445 | Becky Tadlock Ross | Pharmacist | 1766 West Laurel, Rogers, AR 72758 | 2013-08-01 |
| 1497190797 | Medical Associates of Northwest Arkansas Pa | Pediatrics | 3730 S Pinnacle Hills Pkwy Ste 3, Rogers, AR 72758 | 2013-05-01 |
| Find all providers in zip 72758 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417321829 | Paul Allen Colligan | Nurse Anesthetist, Certified Registered | 19571 Sunrise Ct, Rogers, MN 55374-4841 | 2015-11-23 |
| 1780063909 | Nicholas Honea | Nurse Anesthetist, Certified Registered | 4600 Centre Court, Rogers, AR 72758 | 2015-05-20 |
| 1538139704 | Susan Heady Wiseman | Nurse Anesthetist, Certified Registered | 6 Mission Hills Cir, Rogers, AR 72758-1406 | 2006-01-23 |
| 1770560518 | Bradley Wierda | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Lane, Anesthesia Dept, Rogers, AR 72758-1452 | 2005-12-22 |
| 1982029740 | Rachel Spahn | Nurse Anesthetist, Certified Registered | 2710 S Rife Medical Ln, Rogers, AR 72758-1452 | 2014-03-03 |
| 1235571456 | Allison Elizabeth Lee Mckay | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2013-07-30 |
| 1457620478 | Coleman Trey Thrash | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2011-12-20 |
| 1023312782 | Matthew W Shelby | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Anesthesia Dept, Rogers, AR 72758-1452 | 2011-01-10 |
| 1699004648 | Gabriel Chad Underwood | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Anesthesia Department, Rogers, AR 72758-1452 | 2009-12-21 |
| 1932350667 | James M Crim | Nurse Anesthetist, Certified Registered | 2710 Rife Medical Ln, Rogers, AR 72758-1452 | 2008-09-30 |
| Find all providers in ROGERS | ||||
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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.