Derick Duckworth
NPI 1972385300ActiveIndividual· Registered Nurse· Appleton, WI
Registered Nurse with Oregon Anesthesiology Group PC, practicing in Appleton, Wisconsin. Enrolled in Medicare as practitioner - certified registered nurse anesthetist (crna) and practitioner - certified registered nurse anesthetist (crna). Lists Legacy Salmon Creek Medical Center as a hospital affiliation.
Overview
| NPI | 1972385300 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 19, 2023 |
| Last updated in NPPES | Oct 19, 2023 |
| Certified by provider | Oct 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Registered Nurse Primary | 163W00000X | 261171 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (OR); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (WA) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Oregon Anesthesiology Group PCVancouver, WA · 232 clinicians
Hospital affiliation
- Legacy Salmon Creek Medical CenterVancouver, WA
Other Registered Nurse providers in Appleton
- 1255176251
- 1700074689
- 1730083015
- 1184890774
- 1871850644
- 1821224304
- 1639431281
- 1265868400
- 1376563239
- 1265788103
- 1740079367
- 1871515114