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

Dr. Theodore Scott Derse, MD

Individual provider Family Medicine Physician · NPI 1336254515

Dr. Theodore Scott Derse, MD is a Family Practice in Zebulon, North Carolina. Graduated from Uniformed Services Uhs Fe Hebert School of Med in 1992, 34 years ago. Practices with Wake Specialty Physicians LLC, a 178-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois, North Carolina and Wisconsin.

Years since qualifying
34
Trained at
Uniformed Services Uhs Fe Hebert School of Med
Licensed in
IL, NC, WI
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1260 N Arendell Ave
Zebulon, NC 27597-8730
Phone: (919) 235-1965
Show map & directions

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

Additional practice locations (1)

  • 3115 Lewis Ave, Zion, IL 60099-3099 — (847) 746-3752

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2022-01023 (NC)
Family Medicine Physician Taxonomy 207Q00000X · Licence 34915 (WI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036139601 (IL)

Record details

NPI number1336254515
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 20, 2006
Last updated in NPPESMarch 25, 2024
Certification dateMarch 25, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
Graduated 1992 (34 years in practice)
Group practice Wake Specialty Physicians Llc — 178 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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