Individual provider Active NPI

Janel Rebecca Durham, FNP-C

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1154816312
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010644 Issued in NC
Practice address
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 277-2000
Fax
(336) 277-2050
NPI assigned
Jun 28, 2018
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010644 NC Primary

Addresses

Primary practice location

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000

Other practice location 1

10479 N Nc Highway 109 Ste 107A
Winston Salem, NC 27107
Phone (336) 769-0246

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeger142499@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180827000611 NC Practitioner - Nurse Practitioner 6800145764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 22, 2018 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 22, 2018 Accepting new patients
Forsyth Memorial Hospital Inc. CurrentSince Nov 19, 2021 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Nov 19, 2021 Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

7114 Village Medical Cir
Clemmons, NC 27012
Phone (336) 893-2440

189 Samaritans Ridge Rd
Elkin, NC 28621
Phone (336) 526-3003

3515 W Market St
Ste 110
Greensboro, NC 27403
Phone (336) 660-5220

6431 Old Plank Rd
High Point, NC 27265
Phone (336) 875-6530

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

144 Forest Hill Rd
Ste 144146
Lexington, NC 27295
Phone (336) 481-1730

694 Riverside Dr
Mount Airy, NC 27030
Phone (336) 719-7892

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

10479 N NC Highway 109
Ste 107A
Winston Salem, NC 27107
Phone (336) 769-0246

185 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

725 Highland Oaks Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 277-2620

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1154816312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10479 N Nc Highway 109 Ste 107A",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27107",
            "country_code": "US",
            "telephone_number": "336-769-0246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "JANEL",
        "middle_name": "REBECCA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeger142499@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10479 N Nc Highway 109 Ste 107A",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.