Denise Nicole Durham, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

5562 Issued in GA

Practice address

2899 Five Forks Trickum Rd
Lawrenceville, GA 30044-5803

Phone

(770) 982-9969

NPI assigned

Oct 22, 2013

Last updated

Oct 22, 2013By 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 names 1

• Mrs. Denise Nicole Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1649608068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 GUNTER CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300223503",
            "telephone_number": "770-846-6336",
            "fax_number": "847-386-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2899 FIVE FORKS TRICKUM RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445803",
            "telephone_number": "770-982-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "DENISE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "GA",
            "license": "5562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "JOHNSON",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marcia L Dupree, MS, CCC, SLP
• Rolando Duque
• Lori Cdebaca Duran, RN
• Robert Macarthur Duran, MSW
• Joan Burke Durdin, CNM
• Doris Kate Durham
• Sara Mackenzie Taylor Durm
• Duvall Home Care Services LLC
• Emily Wetzel Dye
• Karen Marie Dyer, RN,CCM

• Geriatric Physical Therapist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Geriatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.