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Dr. Derry Dean Dye , MD

Pediatrics β€’ Poplar Bluff, MO

Active NPI 1215949599 Individual Practitioner Male Practitioner
Practice location in NPPES

225 Physicians Park Ste 200
Poplar Bluff, MO 639013921

Call 5737275500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

225 Physicians Park Ste 200

Poplar Bluff, MO 639013921

Telephone 5737275500
Fax 5733133684
Organization at the Same NPPES Address or Phone
Big Springs Medical Association Facility NPI 1558225714

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 26 distinct additional practice-address records in Annapolis, MO; Doniphan, MO; Ellington, MO and 9 more. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $12.20 in 2020

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2020.

Guide: How to read an Open Payments record

NPI first issued

2006

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: NPI first issued

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; Medicare.gov, β€œDoes 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.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Dye has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Dye as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Poplar Bluff and Missouri

12 active clinicians are listed under Pediatrics with a practice address in Poplar Bluff, MO (1,562 in Missouri).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Poplar Bluff

0% of these 12 clinicians have the CMS telehealth indicator.

8.3% of these 12 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2020), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2020
Disclosure Year:

Program year 2020 (payments made January 1 – December 31, 2020): fewer than 11 records totaling $12.20.

Manufacturer Payment Nature Product Type Amount ($)
GlaxoSmithKline, LLC.
Food and Beverage
In-kind items and services
BEXSERO General $12.20

Source: CMS Open Payments, program year 2020, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-22
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES MO R5G11

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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: Missouri Board of Registration for the Healing Arts.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20190829000171

Enrollment State Jurisdiction

MO

PECOS Control ID

6002726940

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

405 Main Street

Van Buren, MO 63965

Phone: 5733234253

109 Leroux St

Doniphan, MO 639351038

Phone: 5739962136

3277 Us Highway 160 W

Doniphan, MO 639355710

Phone: 5738049527

289 Broadway St

Neelyville, MO 639547176

Phone: 5738049494

109 Plum St Ste C

Doniphan, MO 639351225

Phone: 5733510150

225 Physicians Park Ste 104

Poplar Bluff, MO 639013918

Phone: 5734134065

2210 Barron Rd Ste 222

Poplar Bluff, MO 639011906

Phone: 5733510138

225 Physicians Park Ste 304

Poplar Bluff, MO 639013930

Phone: 5737275500

109 Plum St Ste B

Doniphan, MO 639351225

Phone: 5733510220

109 Plum St Ste A

Doniphan, MO 639351225

Phone: 5733510150

61 Highway Y

Ellington, MO 636387802

Phone: 5736632525

1 Hals Plz Ste A

Piedmont, MO 639571631

Phone: 5732234800

17959 Main St

Eminence, MO 654666375

Phone: 5732265505

18 Viburnum Center Rd

Viburnum, MO 655667802

Phone: 5732445406

603 E Summit St

Doniphan, MO 639351142

Phone: 5739963667

711 Nickey St

Poplar Bluff, MO 639016544

Phone: 5737857047

11001 Us-160

Harviell, MO 63945

Phone: 5738049561

315 W Mulberry Ste A

Pilot Knob, MO 636637883

Phone: 5735460602

202 Allen St

Annapolis, MO 636208778

Phone: 5735984213

101 E Batten Street

Naylor, MO 63953

Phone: 5738041779

1300 Victory Ln

Poplar Bluff, MO 639013300

Phone: 5737855566

2300 Baugh Ln

Poplar Bluff, MO 639012402

Phone: 5737853037

225 Physicians Park Ste 102

Poplar Bluff, MO 639013918

Phone: 5737275500

220 East Broad Street

Naylor, MO 63953

Phone: 5733992311

2879 James Blvd

Poplar Bluff, MO 639013395

Phone: 5737121610

2879 James Blvd

Poplar Bluff, MO 639013395

Phone: 5736098800

2210 Barron Rd Ste 120

Poplar Bluff, MO 639011922

Phone: 5737856536

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

31 listed
Christian Bowers , APRN

Nurse Practitioner - Family

NPI 1215305941

Advanced Practice Registered Nurse

Jean Brown , FNP

Nurse Practitioner

NPI 1649399031

Family Nurse Practitioner

Kimberly Buxton , FNP-C

Nurse Practitioner - Family

NPI 1790223709

Family Nurse Practitioner (Certified)

Dr. Fred Caldwell , MD

Internal Medicine

NPI 1558308239

Doctor of Medicine (M.D.)

NPI 1386730232

LICENSEDDIETICIAN

Alicia Cisne , FNP

Nurse Practitioner - Family

NPI 1013482934

Family Nurse Practitioner

Career & Practice History Timeline

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

17 Historical Events
πŸ“
Updated Practice Location June 05, 2026

Registered at 225 PHYSICIANS PARK STE 200, POPLAR BLUFF, MO 639013921 (Tel: 5737275500)

πŸ“
Updated Business Mailing Address June 05, 2026

Registered at 110 S 2ND ST, ELLINGTON, MO 636389400 (Tel: 5736632313)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2026

Pediatrics (license number reported to NPPES: MO R5G11)

πŸ“
Updated Practice Location February 09, 2023

Registered at 225 PHYSICIANS PARK STE 400, POPLAR BLUFF, MO 639013923 (Tel: 5737275500)

πŸ“
Updated Business Mailing Address February 23, 2021

Registered at PO BOX 801143, KANSAS CITY, MO 641801143 (Tel: 5737852005)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2021

General Practice (license number reported to NPPES: MO R5G11)

βœ…
NPI Profile Active July 25, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location July 25, 2017

Registered at 2210 BARRON RD, SUITE 120, POPLAR BLUFF, MO 639011908 (Tel: 5737852005)

πŸ“
Updated Business Mailing Address July 25, 2017

Registered at 2210 BARRON RD, SUITE 120, POPLAR BLUFF, MO 639011908 (Tel: 5737852005)

πŸ‘€
Provider Name / Credentials Updated July 25, 2017

Recorded as DERRY DYE, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2017

Pediatrics (license number reported to NPPES: MO R5G11)

βœ…
NPI Profile Active July 30, 2008

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 30, 2008

Registered at 2210 BARRON RD, SUITE 120, POPLAR BLUFF, MO 639011908 (Tel: 5737852005)

πŸ“
Business Mailing Address (Initial Record) July 30, 2008

Registered at 2210 BARRON RD, SUITE 120, POPLAR BLUFF, MO 639011908 (Tel: 5737852005)

πŸ‘€
Provider Name / Credentials (Initial Record) July 30, 2008

Recorded as DERRY DYE, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2008

Pediatrics (license number reported to NPPES: MO R5G11)

🟒
Initial NPI Registration & Enumeration August 13, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1215949599
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2006
Last Update: July 22, 2026
Sole Proprietor: No

Mailing Address

110 S 2nd St

Ellington, MO 636389400

Phone: 5736632313

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.