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

Derek Maynard, SRNA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1134869589

Derek Maynard, SRNA is a Certified Registered Nurse Anesthetist (CRNA) in Saint Albans, West Virginia. Qualified in 2022, 4 years ago. Practices with Commonwealth Anesthesia, PSC, a 178-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
4
Licensed in
KY
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2106 Shadyside Rd Apt D
Saint Albans, WV 25177-3465
Phone: (304) 687-5771
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 3017779 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1134869589
Entity typeIndividual (Type 1)
GenderMale
Credentials SRNA
Sole proprietorNo
NPI enumeratedMarch 31, 2022
Last updated in NPPESJune 3, 2022
Certification dateJune 3, 2022

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Commonwealth Anesthesia, Psc — 178 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount