MR. DERRICK KIRK WHITE (NPI# 1922380237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922380237 |
| Entity Type | Individual |
| Full Name | MR. DERRICK KIRK WHITE |
| Practice Address |
1161 E 300 N Provo UT 84606-3539 |
| Mailing Address |
750 North 200 West Suite 300 Provo UT 84601 |
| Practice Telephone | 8018524468 |
| Practice Fax Number | 8013754045 |
| Mailing Telephone | 8013734760 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013408517 | Derrick A White | Physical Therapist | 2240 5th Ave Ste 101, Huntington, WV 25703-1290 | 2018-05-21 |
| 1851636021 | Derrick Phillip White | Marriage & Family Therapist | 2667 Camino Del Rio S Ste 301-7, San Diego, CA 92108-3707 | 2012-11-29 |
| 1124474556 | Derrick White | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034 | 2016-05-04 |
| 1356579098 | Derrick Monroe White | Emergency Medical Technician, Paramedic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Ft Rucker, AL 36362-5333 | 2009-07-01 |
| Street Address |
1161 E 300 N |
| City | PROVO |
| State | UT |
| Zip Code | 84606-3539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134220635 | Adrienne I Duffany | Social Worker | 1161 E 300 N, Provo, UT 84606-3539 | 2006-09-26 |
| 1972015675 | Lisa Marion Sladyk | Registered Nurse | 1161 E 300 N, Provo, UT 84606-3539 | 2017-11-02 |
| 1023402302 | Lindsey Feil | Student in an Organized Health Care Education/Training Program | 1161 E 300 N, Provo, UT 84606-3539 | 2015-03-24 |
| 1861720567 | Robin Paul Shepley | Marriage & Family Therapist | 1161 E 300 N, Provo, UT 84606-3539 | 2009-11-18 |
| 1952635005 | Bethany Whitehead | Case Manager/Care Coordinator | 1161 E 300 N, Provo, UT 84606-3539 | 2009-09-22 |
| 1831423037 | Michelle Grotegut | Social Worker | 1161 E 300 N, Provo, UT 84606-3539 | 2009-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
| 1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
| 1700365434 | Hyunwook Lee | Specialist/Technologist | 1369 S 1500 E, Provo, UT 84606 | 2018-08-13 |
| 1598268930 | Victor Bert Arthur Moxley | Specialist | 290 N 300 E, Provo, UT 84606 | 2018-03-12 |
| 1184132623 | Academy Dental LLC | Advanced Practice Dental Therapist | 488 N 100 E St., Provo, UT 84606 | 2018-01-18 |
| 1720433485 | Sean Lamb | Counselor | 231 S. 100 E., Provo, UT 84606 | 2016-05-02 |
| 1508236795 | Forever Young Dentistry Pllc | Clinic/Center | 2335 S. State Street, Ste #200, Provo, UT 84606 | 2015-09-30 |
| 1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
| 1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
| 1558651067 | Melissa Anne Mccreary | Counselor | 151 S.state St. University Ave., Ste 1400, Provo, UT 84606 | 2011-04-18 |
| Find all providers in zip 84606 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710444559 | Kimberlee Hughes | Case Manager/Care Coordinator | 750 N Freedom Blvd Ste 123, Provo, UT 84601-1677 | 2019-02-28 |
| 1174088132 | Jennifer Tecson Narra | Case Manager/Care Coordinator | 655 E 600 N Apt 2, Provo, UT 84606-6945 | 2019-02-04 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1447792015 | Emmanuela Bailey | Case Manager/Care Coordinator | 750 N Freedom Blvd # 200w, Provo, UT 84601-1677 | 2016-11-13 |
| 1073060091 | Kara Traasdahl | Case Manager/Care Coordinator | 189 Wymount Ter, Provo, UT 84604-1934 | 2016-09-07 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1437500691 | Nathan David Astle | Case Manager/Care Coordinator | 1092 E 360 S, Provo, UT 84606-5222 | 2016-06-28 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| Find all providers in PROVO | ||||
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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.