John Derek Durham, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K3572 Issued in TX

Practice address

1128 Clarksville St
Ste. 100
Paris, TX 75460-6060

Phone

(903) 785-4362

Fax

(903) 782-9365

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Texas Tech University Health Science Center School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oro Valley Hospital Hospital, Oro Valley, AZ, CCN 030114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72596

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.

• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment Care Compare group NPD
• Paris Family Physicians,PA

  • Family Medicine Physician
  • Paris, TX
  • NPI 1386614766
  NPD (past)
• Oro Valley Hospital LLC

  • General Acute Care Hospital
  • Oro Valley, AZ
  • NPI 1386697688
  NPD (past)

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

• Oro Valley Hospital LLC

  • General Acute Care Hospital
  • Oro Valley, AZ
  • NPI 1386697688
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1376562942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 CLARKSVILLE ST",
            "address_2": "STE. 100",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754606060",
            "telephone_number": "903-785-4362",
            "fax_number": "903-782-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 CLARKSVILLE ST",
            "address_2": "STE. 100",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754606060",
            "telephone_number": "903-785-4362",
            "fax_number": "903-782-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "JOHN",
        "middle_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K3572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL RAILROAD MC",
            "identifier": "080179154",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR",
            "identifier": "124500",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BLUE CROSS",
            "identifier": "8B5721",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TEXAS HEALTH STEPS",
            "identifier": "144831802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047352202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5967628",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dua Optical Management, LLC
• Dubuis Health System Inc
• Tanganyika Lynn Dudley, APRN, AGACNP-BC
• Sara Dunmon
• Jennifer Dawn Durham, LCSW
• Regina Diane Easlon, D.D.S.
• Kathleen Eastwood
• Jennifer Eatherly, MSN, APRN, NP-C
• Peter Julius Edenhoffer, M.D.
• Elj Inc

• Family Medicine Physician in Paris, TX
• Providers in Paris, 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 Nov 4, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.