Jeremy M. Durham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1651 Issued in KS

Practice address

437 N Tyler Rd
Wichita, KS 67212-3630

Phone

(316) 722-1001

Fax

(316) 722-1073

NPI assigned

Oct 7, 2005

Last updated

Aug 11, 2011By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wichita Family Vision Clinic, P.a.Group PAC ID 2365499928, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wichita Family Vision Clinic, P.a.

  • Optometrist
  • Wichita, KS
  • NPI 1700978244
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1750379368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N TYLER RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123630",
            "telephone_number": "316-722-1001",
            "fax_number": "316-722-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 N TYLER RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123630",
            "telephone_number": "316-722-1001",
            "fax_number": "316-722-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "JEREMY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0803320001",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "650938",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200333580A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Duran, DO
• Tiffany Duran, LPN
• Austin Durant, PHARMD
• Kennedy Elizabeth Durbin
• Chris Durham
• Briana Nicole Dusenbery
• Lesley A Dutchak
• Lauren Ashley Dutcher, LPC
• Kristi S Dutton Speer, MSN, APRN, BC
• Brianna Jo Dutton

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.