Jennifer Rose Durham, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

73253 Issued in WV

Practice address

10003 Webster Rd
Camden on Gauley, WV 26208-7713

Phone

(304) 226-5725

Fax

(304) 226-3274

NPI assigned

Sep 11, 2013

Last updated

Jan 11, 2023By the provider in NPPES

Sex

Female

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 2

Other names 1

• Jennifer Rose Gates Former name

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camden on Gauley Medical Center IncGroup PAC ID 6002867850, shared by 25 NPIs, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summersville Regional Medical Center Hospital, Summersville, WV, CCN 511322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.durham@cog-wv.directbygreenway.com

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.

• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Nettie, WV
  • NPI 1174065916
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health-Red Oak

  • Federally Qualified Health Center (FQHC)
  • Craigsville, WV
  • NPI 1215394648
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1245938513
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1508372228
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1700312618
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Ansted, WV
  • NPI 1801493499
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health (lewis)

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1861872541
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc.

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1811420250
  Medicare reassignment NPD
• Camden on Gauley Medical Center, Inc.

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1669947222
  Medicare reassignment NPD
• Camden on Gauley Medical Center, Inc

  dba Camden Family Health (Cowen Location)

  • Federally Qualified Health Center (FQHC)
  • Cowen, WV
  • NPI 1639418361
  Medicare reassignment
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Craigsville, WV
  • NPI 1427585157
  NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1558174086
  NPD

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

• West Virginia Health Care Cooperative Inc

  dba Summersville Regional Medical Center

  • Critical Access Hospital
  • Summersville, WV
  • NPI 1043778319
  Care Compare affiliation
• West Virginia Health Care Cooperative Inc

  dba SRMC Medical Group

  • Hospitalist Physician
  • Summersville, WV
  • NPI 1417415324
  Care Compare affiliation

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1629403563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "73253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026528",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "WV3488A",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GATES",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meagan Brooke Cavender, MSW, LGSW
• Emily Susan Clagg, D.O.
• Elizabeth Ann Coffman, FNP-BC
• Stephanie Cool
• Hannah Dorsey
• Holly Fitzwater, APRN
• Heather Dawn Glasko-Tully, MSN, APRN, NP-C, FNP
• Jennifer Hall, MSW, LICSW
• Mark J Hardway, M.D.
• Lisa Ellen Henthorn, LPC, NCC

• Family Nurse Practitioner in Camden on Gauley, WV
• Providers in Camden on Gauley, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.
• 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.