MARY M DERKSEN (CNS) – Psychiatric/Mental Health Nurse Practitioner, NPI 1194749812

Psychiatric/Mental Health Nurse Practitioner

MARY M DERKSEN (CNS) is a healthcare provider. based in Holland, Michigan. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold the professional credentials CNS. They hold a License No. 4704158809 (MI). The NPI Number for MARY M DERKSEN (CNS) is 1194749812

Main info

Female

21 Years Of Experience

Accepts Medicare Assignment

Name

MARY M DERKSEN (CNS)

NPI

1194749812

Phone

(616) 494-5453

Address

12265 JAMES ST

Enumeration Date

26 July 2006

Last Update Date

13 February 2012

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6163935641

Graduation Year

2005 (21 years ago)

PAC ID

8527075373

Group Practice PAC ID

0042118036

Professional Enrollment ID

I20060320000370

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience52

Completeness75

Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MARY M DERKSEN (CNS)

12265, James Street, Holland Charter Township, Ottawa County, Michigan, 49424, United States
HOLLAND, MI 494248613
Phone: (616) 494-5453
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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 49424)

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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: 0042118036View full group profile

Name	Specialty	State
RHONDA MARIE RUTAN (LLMSW)	Clinical Social Worker	MI
CARRIE PERNESKY (LMSW)	Clinical Social Worker	MI
MS. SANDRA CANDY CASTLE (LLP)	Clinical Social Worker	MI
MAUREEN MARY RUSSELL (LMSW)	-	MI
CHRISTIAN MCDANIEL (CSW)	Clinical Social Worker	MI
MATTHEW VANDERHYDE	Clinical Social Worker	MI
KYLE KLAASEN	Clinical Social Worker	MI
ANN CUDNEY (NP)	Nurse Practitioner	MI
NICOLE BOWYER	Clinical Social Worker	MI
AUTUMN PUTNAM	Clinical Social Worker	MI

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Frequently asked questions

How do payers reference MARY M DERKSEN (CNS)?

For MARY M DERKSEN (CNS), use NPI 1194749812 as the unique 10-digit identifier.

Active or inactive — what applies to MARY M DERKSEN (CNS)?

You should see MARY M DERKSEN (CNS) as active in CMS-hosted NPPES data.

What kind of doctor is MARY M DERKSEN (CNS)?

MARY M DERKSEN (CNS) is associated with Psychiatric/Mental Health Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.

Where in Michigan is MARY M DERKSEN (CNS) registered?

Use Holland, Michigan as the headline location for MARY M DERKSEN (CNS) here.

Can I trust this NPI listing for MARY M DERKSEN (CNS)?

The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.