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
Mailing address3327 N Casaloma Dr Unit 197, Appleton, WI 54913-7963

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