Dr. Dereck A. Peery
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

Address: 915 10th Ave Nw, Ardmore, OK 73401-4025
Phone: 5802237200

Dr. Dereck A. Peery (NPI# 1164543203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1164543203
Entity Type Individual
Full Name Dr. Dereck A. Peery
Credential D.O.
Gender Male
Practice Address 915 10th Ave Nw
Ardmore
OK 73401-4025
Practice Telephone 5802237200
Practice Fax Number 5802237207
Mailing Address 915 10th Ave Nw
Ardmore
OK 73401-4025
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2007-04-03
Last Update Date 2009-07-23

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207XS0117X Orthopaedic Surgery · Orthopaedic Surgery of the Spine Allopathic & Osteopathic Physicians 4546 OK

Other Provider Identifier

State Identifier Issuer Type Code
OK 200124470A MEDICAID
OK OK700279 OTHER INDIVIDUAL PTAN
P00442554 OTHER RAILROAD MEDICARE

Physician Overview

NPI 1164543203
PAC ID by PECOS 3375638844
Professional Enrollment ID I20070927001030
Full Name Dereck A Peery
Organization Legal Name MERCY CLINIC OKLAHOMA COMMUNITIES
Phone Number 4057551515
Gender M
Medical School KANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS
Graduation Year 2001
Primary Specialty ORTHOPEDIC SURGERY
Group Practice PAC ID 1153468921
Number of Group Practice Members 420
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
370047 MERCY HOSPITAL ARDMORE, INC
370020 MERCY HOSPITAL ADA
370023 DUNCAN REGIONAL HOSPITAL, INC
370014 ALLIANCEHEALTH DURANT

Office Location

Street Address 915 10TH AVE NW
City ARDMORE
State OK
Zip Code 73401-4025

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366406217 Bolaji S. Sofola Urology 915 10th Ave Nw, Ardmore, OK 73401-4025 2006-04-15
1790030492 Stacey R Ogden Specialist/Technologist 915 10th Ave Nw, Ardmore, OK 73401-4025 2012-07-18
1245501105 Aaron Spells Physician Assistant 915 10th Ave Nw, Ardmore, OK 73401-4025 2012-01-24
1629397252 Elizabeth Gannon Speech-Language Pathologist 915 10th Ave Nw, Ardmore, OK 73401-4025 2010-05-21
1265760508 Sneha Pranjal Desai Obstetrics & Gynecology 915 10th Ave Nw, Ardmore, OK 73401 2009-11-25
1215192265 Spine Transformation LLC Orthopaedic Surgery 915 10th Ave Nw, Ardmore, OK 73401-4025 2008-07-18
1942322128 Donna Sue Edge Childs Occupational Therapist 915 10th Ave Nw, Ardmore, OK 73401-4025 2007-04-06
1881609568 Urology Center of Southern Oklahoma,pc Urology 915 10th Ave Nw, Ardmore, OK 73401-4025 2006-07-30
1639133580 Hayden D. Henry Urology 915 10th Ave Nw, Ardmore, OK 73401-4025 2006-04-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790349991 Shirley Denise Brown Licensed Psychiatric Technician 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 2019-04-24
1427512359 Billy Joe Oshields Case Manager/Care Coordinator 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 2019-01-24
1174007595 Tawnya Dawn Peery Nurse Practitioner 1108 W. Walnut Drive, Ardmore, OK 73401 2018-09-21
1679055016 Teresa Marie Hernandez Behavior Technician 1219 K St. Nw, Ardmore, OK 73401 2018-09-01
1063991974 Sawyer Rae Shamburger Occupational Therapy Assistant 208 North Praire St, Pilot Point, TX 73401 2018-08-10
1417473521 Chelsye Bacon Peer Specialist 905 Holiday Drive, Ardmore, OK 73401 2017-08-21
1003279746 Jeni Presley Marriage & Family Therapist Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 2016-03-31
1982080909 Alison Hill Pharmacist 1111 N. Commerce, Ardmore, OK 73401 2015-07-31
1316346547 Olivia Larae Carrell Counselor 15 Monroe Street Ne, Ardmore, OK 73401 2014-08-13
1902218548 Tabathya Lane Nurse Practitioner 1001 12th Ave Nw, Suite 100, Ardmore, OK 73401 2014-06-02
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Taxonomy Information

Taxonomy Code 207XS0117X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Orthopaedic Surgery of the Spine

Taxonomy Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215192265 Spine Transformation LLC Orthopaedic Surgery 915 10th Ave Nw, Ardmore, OK 73401-4025 2008-07-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255893335 Sok Care of Ok, LLC Orthopaedic Surgery 10601 S Western Ave Ste 3, Oklahoma City, OK 73170-6201 2019-04-05
1578036448 Minimally Invasive Spine Institute Pllc Orthopaedic Surgery 10131 S Yale Ave Ste 202, Tulsa, OK 74137-6069 2019-01-03
1568934859 Orthopedic Spine Associates Orthopaedic Surgery 14100 Parkway Commons Dr Ste 101, Oklahoma City, OK 73134-6036 2018-12-26
1013488048 Essential Integrative Health Pllc Orthopaedic Surgery 3705 Nw 63rd St Ste 201, Oklahoma City, OK 73116-1937 2018-12-17
1619476561 Joint Replacement Cin of Oklahoma City LLC Orthopaedic Surgery 10601 S Western Ave # 2, Oklahoma City, OK 73170-6201 2018-02-06
1154820009 Spine Cin of Oklahoma City LLC Orthopaedic Surgery 10601 S Western Ave # 1, Oklahoma City, OK 73170-6201 2018-02-06
1952724494 Jeffrey Schimandle Orthopaedic Surgery 6112 N Villa Ave, Oklahoma City, OK 73112-7159 2014-02-03
1659627289 Southwest Orthopaedic Specialists, Pllc Orthopaedic Surgery 2506 North Harrison Avenue, Shawnee, OK 74804-4022 2012-08-01
1831270511 Ernest Alexander L'heureux Jr. Orthopaedic Surgery 1405 Nw 150th St, Edmond, OK 73013-1305 2006-10-18
1043282957 Sloane Roxanne Blair Orthopaedic Surgery 110 Nw 31st Street, 2nd Floor, Lawton, OK 73502-0785 2006-02-03
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City ARDMORE
Zip Code 73401

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Dataset Information

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.

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