Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Derick Duckworth

Individual provider Registered Nurse · NPI 1972385300

Derick Duckworth is a Certified Registered Nurse Anesthetist (CRNA) in Appleton, Wisconsin. Qualified in 2025, 1 year ago. Practices with Oregon Anesthesiology Group PC, a 233-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
1
Licensed in
WI
In the registry since
2023
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Practice location Address checks out

3327 N Casaloma Dr Unit 197
Appleton, WI 54913-7963
Phone: (360) 620-2644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 261171 (WI)

Record details

NPI number1972385300
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 19, 2023
Last updated in NPPESOctober 19, 2023
Certification dateOctober 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Oregon Anesthesiology Group Pc — 233 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Appleton