Rebecca D Derby, NP - Medicare Nurse Practitioner in Clarksville, TN

Rebecca D Derby, NP is a medicare enrolled "Nurse Practitioner" in Clarksville, Tennessee. Her current practice location is 980 Professional Park Dr, Ste. C, Clarksville, Tennessee. You can reach out to her office (for appointments etc.) via phone at (931) 647-5747.

Rebecca D Derby is licensed to practice in Tennessee (license number 20361) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053789149.

Contact Information

Rebecca D Derby, NP
980 Professional Park Dr, Ste. C,
Clarksville, TN 37040-5251
(931) 647-5747
Not Available



Provider's Profile

Full NameRebecca D Derby
GenderFemale
SpecialityNurse Practitioner
Location980 Professional Park Dr, Clarksville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053789149
  • Provider Enumeration Date: 09/08/2015
  • Last Update Date: 07/01/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 3870802432
  • Enrollment ID: I20151021001985

Medical Identifiers

Medical identifiers for Rebecca D Derby such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053789149NPI-NPPES
Q016334MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 20361 (Tennessee)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Rebecca D Derby allows following entities to bill medicare on her behalf.
Entity NameSoutheastern Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356379382
PECOS PAC ID: 2466364997
Enrollment ID: O20050125000997

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Entity NameApp Of Tennessee Ed Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003230236
PECOS PAC ID: 8123251766
Enrollment ID: O20140506000159

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Entity NameHavely Springs Emergency Group, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770090110
PECOS PAC ID: 6204298144
Enrollment ID: O20230809003314

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Rebecca D Derby is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Rebecca D Derby, NP
Po Box 681789,
Franklin, TN 37068-1789

Ph: () -
Rebecca D Derby, NP
980 Professional Park Dr, Ste. C,
Clarksville, TN 37040-5251

Ph: (931) 647-5747

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› Verified 1 days ago


Nurse Practitioner Nurses in Clarksville, TN

Amber L Schacht, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 881 Professional Park Dr, Clarksville, TN 37040
Phone: 931-645-4685    Fax: 931-245-2117
Mrs. Brittney Wilkinson Lesser, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 647 Dunlop Ln Ste 301, Clarksville, TN 37040
Phone: 931-431-4677    
Katherine R Harrison, PNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 800 Weatherly, Suite 201, Clarksville, TN 37043
Phone: 931-648-1912    Fax: 931-648-1277
Danielle Reine Schaaf, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 350 Pageant Ln Ste 307, Clarksville, TN 37040
Phone: 931-906-2001    
Willie Lance Lemusu, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 103 Jefferson St, Clarksville, TN 37040
Phone: 931-266-4999    
Jennifer A Nelson, CPNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 111 Otis Smith Dr, Clarksville, TN 37043
Phone: 931-553-6666    Fax: 931-553-4006
Kristina Reilly, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 236 Uffelman Dr, Clarksville, TN 37043
Phone: 931-647-6305    

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