Individual provider Active NPI

Debra A Durham, M.D.

  • Internal Medicine Physician
  • Parks, LA
National Provider Identifier
1386646677
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
018627 Issued in LA
Practice address
1027-A Martin Street
Parks, LA 70582
Phone
(337) 845-4900
Fax
(337) 845-5288
NPI assigned
Jun 1, 2005
Last updated
May 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 018627 LA Primary

Addresses

Primary practice location

1027-A Martin Street
Parks, LA 70582

Mailing address

PO Box 62622 Dept 1721
New Orleans, LA 70162-2600
Phone (337) 706-1605

Other identifiers 1

IdentifierTypeStateIssuer
1920959MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20101004001134 LA Practitioner - Internal Medicine 5395937700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

4212 W Congress St
Family Health Plaza
Lafayette, LA 70506-6765
Phone (337) 216-9018

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
018627LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Health Ventures Inc CurrentSince Jul 16, 2010 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Lafayette Health Ventures, Inc Internal Medicine CurrentSince Jul 16, 2010 Accepting new patients

Locations

4212 W Congress St
Lafayette, LA 70506
Phone (337) 216-9018

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

900 E Saint Mary Blvd
Ste 106
Lafayette, LA 70503
Phone (337) 289-8861

1027 Martin St
#A
Parks, LA 70582
Phone (337) 845-4900

Interoperability endpoints

  • Direct secure messaging: ddurham1099172@direct.ochsner.org

Organizations & group practices 3

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 7

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1386646677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62622 DEPT 1721",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701622600",
            "telephone_number": "337-706-1605",
            "fax_number": "337-981-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027-A MARTIN STREET",
            "city": "PARKS",
            "state": "LA",
            "postal_code": "70582",
            "telephone_number": "337-845-4900",
            "fax_number": "337-845-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "018627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1920959",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parks, LA

Sources for this page

Verify at the official NPI Registry.