The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-04-29

Non-emergency Medical Transport (VAN) Primary Specialty

NUCC Taxonomy Code: 343900000X

A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events

🔄

NPI Profile Reactivated August 06, 2024

Record officially reactivated for active practice on August 06, 2024

⚠️

NPI Profile Deactivated July 15, 2024

NPPES lists this NPI as deactivated as of July 15, 2024; the reason is not published.

✅

NPI Profile Active April 29, 2022

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) April 29, 2022

Registered at 1161 PINEGLEN DR, RIVERDALE, GA 302963223 (Tel: 2513823621)

📍

Business Mailing Address (Initial Record) April 29, 2022

Registered at 1161 PINEGLEN DR, RIVERDALE, GA 302963223 (Tel: 2513823621)

👤

Provider Name / Credentials (Initial Record) April 29, 2022

Recorded as DERRICKAH GARDNER

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2022

Non-emergency Medical Transport (VAN)

🟢

Initial NPI Registration & Enumeration April 29, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1548905946

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 29, 2022

Last Update: August 06, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1161 Pineglen Dr

Riverdale, GA 302963223

Phone: 2513823621

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.