DEREK REED DOORN – Family Nurse Practitioner, NPI 1063901460

DEREK REED DOORN is a healthcare provider. based in Holyoke, Colorado. specializing in NURSE PRACTITIONER. They hold a License No. APN.0993763-NP (CO). The NPI Number for DEREK REED DOORN is 1063901460

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DEREK REED DOORN
NPI
1063901460
Phone
(970) 466-1432
Address
14426 COUNTY ROAD 51
Enumeration Date
2 May 2018
Last Update Date
26 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
97085422412130
Graduation Year
2017 (9 years ago)
PAC ID
9638425317
Group Practice PAC ID
9638161615
Professional Enrollment ID
I20180711000862
Address ID
CO807341854HO1001XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

5,198 NURSE PRACTITIONER in CO

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Provider Addresses for DEREK REED DOORN

  • 51, County Road, Holyoke, Hampden County, Massachusetts, 01040, United States

    HOLYOKE, CO 807349553

    Phone: (970) 466-1432

    Type: Mailing

  • Melissa Memorial Hospital, 1001, East Johnson Street, Holyoke, Phillips County, Colorado, 80734, United States

    HOLYOKE, CO 807341854

    Phone: (970) 854-2241

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-11-09 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180711000862INurse PractitionerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80734)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638161615View full group profile
NameSpecialtyState
Mental Health CounselorSD
Family PracticeCO
Family PracticeFL
Family PracticeCO
Physician AssistantVA
-ID
Mental Health CounselorCO
Nurse PractitionerWA
-CO
Nurse PractitionerNE

Reviews

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Frequently asked questions

What is the 10-digit NPI for DEREK REED DOORN?
DEREK REED DOORN — NPI 1063901460 — is the standard way to identify this listing.
Does the file indicate DEREK REED DOORN is practicing under active NPI?
Directory data currently reports DEREK REED DOORN as active.
What taxonomy line describes DEREK REED DOORN?
For research purposes, treat DEREK REED DOORN as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DEREK REED DOORN on a map?
Expect Holyoke, Colorado as a primary anchor for DEREK REED DOORN unless the record lists multiple sites.
Is the information about DEREK REED DOORN up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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