NPIMap

Individual provider Active NPI

Jennifer Durham, DNP-AGPCNP

  • Gerontology Nurse Practitioner
  • Danville, VA
National Provider Identifier
1629776984
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024188273 Issued in VA
Practice address
158 Executive Dr
Danville, VA 24541-4100
Phone
(434) 791-1088
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 256042 NC
Primary Care Nurse Practitioner 363LP2300X 0024188273 VA
Gerontology Nurse Practitioner 363LG0600X 0024188273 VA Primary

Addresses

Primary practice location

158 Executive Dr
Danville, VA 24541-4100

Mailing address

405 Thompson St
Eden, NC 27288-5045
Phone (336) 627-4896

Other practice location 1

147 Elvin Durham Rd
Pelham, NC 27311-8635
Phone (434) 441-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250128000766 VA Practitioner - Nurse Practitioner 3577092147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

201 S Main St
Suite 1100
Danville, VA 24541-2938
Phone (434) 791-3009

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256042NCMDRegistered Nurse
0024188273VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Consultants of Danville CurrentSince Jan 12, 2025 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients
Danville Physician Practices LLC CurrentSince Oct 10, 2024 Accepting new patients
Danville Physician Practices LLC CurrentSince Oct 10, 2024 Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

201 S Main St
Ste 1100
Danville, VA 24541
Phone (434) 791-3009

158 Executive Dr
Danville, VA 24541
Phone (434) 228-7603

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.484907
  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
  • Direct secure messaging: jennifer.durham.1@19847.direct.athenahealth.com

Organizations & group practices 4

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 9

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1629776984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 THOMPSON ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885045",
            "telephone_number": "336-627-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 EXECUTIVE DR",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414100",
            "telephone_number": "434-791-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Elvin Durham Rd",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "NC",
            "postal_code": "273118635",
            "country_code": "US",
            "telephone_number": "434-441-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "JENNIFER",
        "credential": "DNP-AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "256042",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024188273",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024188273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.