Active NPI
Darnell Autry Durrah Jr., PHD
- Psychologist
- Fort Irwin, CA
National Provider Identifier
1063746931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0004816
- Practice address
- Weed Army Community Hospital BLD 390
Fort Irwin, CA 92310 - Phone
- (760) 383-5440
- NPI assigned
- Sep 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0004816 | CO | Primary |
Addresses
Primary practice location
Weed Army Community Hospital BLD 390
Fort Irwin, CA 92310
Mailing address
2332 Harney Rd
Fort Sam Houston, TX 78234-7508
Phone (210) 539-9567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0004816 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1063746931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2332 HARNEY RD",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782347508",
"telephone_number": "210-539-9567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WEED ARMY COMMUNITY HOSPITAL BLD 390",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "760-383-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURRAH",
"first_name": "DARNELL",
"middle_name": "AUTRY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-25",
"last_updated": "2023-06-28",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "0004816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.