Mrs Kiwana N Derrick, RN, AGNP-C - Medicare Nurse Practitioner in Shelbyville, TN

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Mrs Kiwana N Derrick, RN, AGNP-C is a medicare enrolled "Nurse Practitioner" in Shelbyville, Tennessee. Her current practice location is 835 Union St, Shelbyville, Tennessee. You can reach out to her office (for appointments etc.) via phone at (931) 680-2300.

Mrs Kiwana N Derrick is licensed to practice in Tennessee (license number APN0000028011) 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 1871105320.

Contact Information

Mrs Kiwana N Derrick, RN, AGNP-C
835 Union St,
Shelbyville, TN 37160-2607
(931) 680-2300
Not Available

Map and Direction




Provider's Profile

Full NameMrs Kiwana N Derrick
GenderFemale
SpecialityNurse Practitioner
Location835 Union St, Shelbyville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1871105320
  • Provider Enumeration Date: 08/17/2020
  • Last Update Date: 05/04/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 5294132478
  • Enrollment ID: I20210930003005

Medical Identifiers

Medical identifiers for Mrs Kiwana N Derrick such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871105320NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner APN0000028011 (Tennessee)Primary
163WG0600XRegistered Nurse - Gerontology 196202 (Tennessee)Secondary

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. Mrs Kiwana N Derrick allows following entities to bill medicare on her behalf.
Entity NamePremier Internal Medicine Of Giles County, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962662270
PECOS PAC ID: 1052489200
Enrollment ID: O20081001000603
Entity NameCurana Health Of Tennessee Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750761060
PECOS PAC ID: 7416261482
Enrollment ID: O20150804005400
Entity NameTennessee Health Partners Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326603911
PECOS PAC ID: 0840625984
Enrollment ID: O20200116003126
Entity NameCh Mssp Services Tn Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003575838
PECOS PAC ID: 0042603656
Enrollment ID: O20220203000451

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. Mrs Kiwana N Derrick 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
Mrs Kiwana N Derrick, RN, AGNP-C
Po Box 2182,
Lewisburg, TN 37091-1182

Ph: (931) 652-2521		Mrs Kiwana N Derrick, RN, AGNP-C
835 Union St,
Shelbyville, TN 37160-2607

Ph: (931) 680-2300

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.