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Individual provider Active NPI

Charlene Michele Durham, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1326640830
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014708 Issued in KY
Practice address
1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone
(502) 367-3360
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3014708 KY
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 3014708 KY Primary

Addresses

Primary practice location

1850 Bluegrass Ave
Louisville, KY 40215-1161

Mailing address

PO Box 909
Louisville, KY 40201-0909

Other names 1

  • Charlene Michele Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223003073 KY Practitioner - Nurse Practitioner 8325453426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone (502) 367-3360

727 Hospital Dr
Shelbyville, KY 40065-1660
Phone (602) 647-4000

Hospital & facility affiliations

  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3014708KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. Single Specialty CurrentSince Jan 4, 2021 Accepting new patients
University of Louisville Physicians Inc. Single Specialty CurrentSince Jan 4, 2021 Accepting new patients
University of Louisville Physicians, Inc. Single Specialty Current Accepting new patients
University of Louisville Physicians, Inc. Single Specialty Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

3920 Dutchmans Ln
Louisville, KY 40207
Phone (502) 259-6000

727 Hospital Dr
Shelbyville, KY 40065
Phone (502) 633-2345

Organizations & group practices 5

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1326640830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-367-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "CHARLENE",
        "middle_name": "MICHELE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014708",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "MILLER",
            "middle_name": "MICHELE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.