Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kirsten Bailey Dericks, PA-C

Individual provider Physician Assistant · NPI 1689353930

Kirsten Bailey Dericks, PA-C is a Physician Assistant in New Albany, Indiana. Qualified in 2023, 3 years ago. Practices with North Clark Medical Group LLC, a 20-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3211 Grant Line Rd Ste 15
New Albany, IN 47150-2175
Phone: (812) 221-1186
Fax: (949) 882-0452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1689353930
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 13, 2023
Last updated in NPPESApril 9, 2026
Certification dateApril 9, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice North Clark Medical Group Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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