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

Robert John Derby, NP

Individual provider Nurse Practitioner · NPI 1104593060

Robert John Derby, NP is a Nurse Practitioner in Beloit, Wisconsin. Qualified in 2021, 5 years ago. Practices with Beloit Health System Inc, a 141-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
5
Licensed in
IL, WI
In the registry since
2021
Specialties on file
3
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Partly verified

Some contact details are missing from the federal record.

Beloit Clinic 1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone: (608) 364-1640
Fax: (608) 363-7393
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 11369-33 (WI)
Nurse Practitioner Taxonomy 363L00000X · Licence 209024153 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 11369-33 (WI)

Record details

NPI number1104593060
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 26, 2021
Last updated in NPPESDecember 4, 2023
Certification dateJune 16, 2022
Mailing addressBeloit Health Systems Inc, 1969 W Hart Road, Beloit, WI 53511-2230

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Beloit Health System Inc — 141 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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