Shelley Erin Durham, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N0948 Issued in TX

Practice address

5120 Conchos TRL
Arlington, TX 76017-3024

Phone

(817) 966-8550

NPI assigned

Jun 26, 2007

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shelley Erin Haven Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• S & J Direct Primary Care, PLLC

  dba Durham Direct Primary Care

  • Primary Care Clinic/Center
  • Arlington, TX
  • NPI 1194493536
  NPD Authorized official
• Family Healthcare Associates

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1831159466
  NPD (past)
• Steve Longacre M.D. PA

  • Emergency Medicine Physician
  • Bridgeport, TX
  • NPI 1609015072
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1184820953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 836",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760630836",
            "telephone_number": "817-966-8550",
            "fax_number": "817-612-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 CONCHOS TRL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760173024",
            "telephone_number": "817-966-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "SHELLEY",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "HAVEN",
            "middle_name": "ERIN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aeschel L Duran, APRN
• Lauren Durand
• Durbin Family Practice PA
• Sherril Durbin, D.O.
• Sharon Durham
• Ifeanyi Duruewuru, FNP-C
• Linda Shelton Dutton, C.N.P.
• Christopher Ryan Dwyer, M.D.
• Dynamic Healthcare Consulting Agency LLC
• Dynamix Adult Day Care Services, LLC.

• Family Medicine Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.