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

Derek Nickerson, CRNA

Individual provider Registered Nurse · NPI 1639576614

Derek Nickerson, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Greenville, South Carolina. Qualified in 2014, 12 years ago. Practices with Prisma Health University Medical Group, a 2,446-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and South Carolina.

Years since qualifying
12
Licensed in
FL, SC
In the registry since
2014
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone: (864) 522-3700
Fax: (864) 522-3705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 701 Grove Rd, Greenville, SC 29605-4210 — (864) 455-7000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 19269 (SC)
Registered Nurse Taxonomy 163W00000X · Licence RN9298682 (FL)

Record details

NPI number1639576614
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedNovember 19, 2014
Last updated in NPPESMay 6, 2024
Certification dateMay 6, 2024

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Prisma Health University Medical Group — 2446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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