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Active NPI 1104691153 Individual Practitioner Female Practitioner

Susan Kay Derrickson , NP-BC

Nurse Practitioner • Goshen, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Susan Derrickson, NP-BC is a certified Nurse Practitioner practicing in Goshen, IN. With approximately 5 years of clinical experience since completing medical education in 2021, Susan Derrickson delivers high-quality medical care to the local community at 213 MIDDLEBURY ST.

Susan Derrickson maintains professional affiliations with Maple City Health Care Center Inc, Nephrology Physicians, Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

213 Middlebury St

Goshen, IN 465282956

Telephone 5745343300
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Goshen, IN

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -3.8 yrs vs City Avg
City Avg: 8.8 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
25 Specialists

Practicing in Goshen, IN (2620 Statewide)

Telehealth Adoption Rate
8.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Derrickson (5 Years) 5 Yrs
Goshen Specialty Average (8.8 Years) 8.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-03-10
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IN 71014637A

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Maple City Health Care Center Inc

213 Middlebury St, Goshen, IN 465282956

Phone: 5745343300

Nephrology Physicians, Llc

710 Park Pl, Mishawaka, IN 465453519

Phone: 5742736767

Secondary Practice Locations

808 N 3rd St

Goshen, IN 465287100

Phone: 5745340088

2606 Peddlers Village Rd Ste 210

Goshen, IN 465261004

Phone: 5745343300

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
Kaitlyn Delgado , FNP-BC

Nurse Practitioner - Family

NPI 1013786227

Family Nurse Practitioner (Board Certified)

Ingrid Moser , RD

Dietitian, Registered

NPI 1093034787

Registered Dietitian

Dr. Thomas Kreider , MD

Psychiatry & Neurology - Psychiatry

NPI 1093770547

Doctor of Medicine (M.D.)

Amanda Yeazel

Nurse Practitioner - Primary Care

NPI 1144115833
NPI 1205483393

Doctor of Pharmacy (Pharm.D.)

NPI 1265640304

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2026

Nurse Practitioner (License #71014637A in IN)

NPI Profile Active November 21, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location November 21, 2023

Registered at 213 MIDDLEBURY ST, GOSHEN, IN 465282956 (Tel: 5745343300)

📍
Updated Business Mailing Address November 21, 2023

Registered at 2024 MAPLEHURST AVE, MISHAWAKA, IN 465457006 (Tel: 5743021640)

👤
Provider Name / Credentials Updated November 21, 2023

Recorded as SUSAN DERRICKSON, NP-BC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2023

Family Medicine (License #71014637A in IN)

🟢
Initial NPI Registration & Enumeration November 20, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104691153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 20, 2023
Last Update: March 10, 2026
Sole Proprietor: No

Mailing Address

2024 Maplehurst Ave

Mishawaka, IN 465457006

Phone: 5743021640

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.