Individual provider Active NPI

Roxann Durham, PH.D.

  • Psychologist
  • Jefferson City, MO
National Provider Identifier
1730164609
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2000175010 Issued in MO
Practice address
211 Oscar Dr
Suite a
Jefferson City, MO 65101-5197
Phone
(573) 635-8299
Fax
(573) 635-4629
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2000175010 MO Primary

Addresses

Primary practice location

211 Oscar Dr
Suite a
Jefferson City, MO 65101-5197

Mailing address

211 Oscar Dr
Suite a
Jefferson City, MO 65101-5197
Phone (573) 635-8299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2000175010MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Grove Counseling Past Accepting new patients
Spring Grove Counseling Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730164609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 OSCAR DR",
            "address_2": "SUITE A",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015197",
            "telephone_number": "573-635-8299",
            "fax_number": "573-635-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 OSCAR DR",
            "address_2": "SUITE A",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015197",
            "telephone_number": "573-635-8299",
            "fax_number": "573-635-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "ROXANN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2000175010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.