Individual provider Active NPI

Tayla Lyn Durant, NP

  • Pediatric Nurse Practitioner
  • Potsdam, NY
National Provider Identifier
1114531670
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383188 Issued in NY
Practice address
15 Raymond St
Potsdam, NY 13676-1163
Phone
(315) 265-9271
NPI assigned
Sep 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383188 NY Primary

Addresses

Primary practice location

15 Raymond St
Potsdam, NY 13676-1163

Mailing address

50 Leroy St
Potsdam, NY 13676-1786

Other practice location 1

899 State Highway 11C
Brasher Falls, NY 13613-4118
Phone (315) 389-5181

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tdurant343744@direct.rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220409000367 NY Practitioner - Nurse Practitioner 9436545910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
383188NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canton-Potsdam Hospital CurrentSince Apr 18, 2022 Accepting new patients
Canton-Potsdam Hospital CurrentSince Apr 18, 2022 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients
Benardot Pediatrics, PLLC PastSince Sep 1, 2020 Accepting new patients

Locations

15 Raymond St
Potsdam, NY 13676
Phone (315) 265-1055

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Interoperability endpoints

  • Direct secure messaging: tdurant343744@direct.rochesterregional.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1114531670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RAYMOND ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761163",
            "telephone_number": "315-265-9271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "899 State Highway 11C",
            "address_purpose": "LOCATION",
            "city": "Brasher Falls",
            "state": "NY",
            "postal_code": "136134118",
            "country_code": "US",
            "telephone_number": "315-389-5181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURANT",
        "first_name": "TAYLA",
        "middle_name": "LYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdurant343744@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "15 Raymond St",
            "city": "Potsdam",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136761163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.