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

Derek Christopher Braddix

Individual provider Family Nurse Practitioner · NPI 1588110480

Derek Christopher Braddix is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2016, 10 years ago. Practices with Theoria Medical, a 342-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
10
Licensed in
MO
In the registry since
2016
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Practice location Address checks out

9717 Landmark Parkway Dr
Saint Louis, MO 63127-1628
Phone: (775) 423-6400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2016025007 (MO)

Record details

NPI number1588110480
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 30, 2016
Last updated in NPPESSeptember 28, 2020
Certification dateSeptember 28, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Theoria Medical — 342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Saint Louis