Active NPI
Kenan Durham
- Clinical Social Worker
- Greensboro, NC
National Provider Identifier
1235875097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P016938
- Practice address
- 3107 S Elm Eugene St Ste a
Greensboro, NC 27406-5298 - Phone
- (336) 273-2640
- Fax
- (336) 273-6522
- NPI assigned
- May 5, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P016938 | NC | Primary |
Addresses
Primary practice location
3107 S Elm Eugene St Ste a
Greensboro, NC 27406-5298
Mailing address
PO Box 14884
Greensboro, NC 27415-4884
Phone (336) 273-2640
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P016938 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1235875097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14884",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274154884",
"telephone_number": "336-273-2640",
"fax_number": "336-273-6522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3107 S ELM EUGENE ST STE A",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274065298",
"telephone_number": "336-273-2640",
"fax_number": "336-273-6522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "KENAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-05",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P016938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.