Individual provider Active NPI

John Raymond Durant, MD

  • General Practice Physician
  • Dadeville, AL
National Provider Identifier
1790717858
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19640 Issued in AL
Practice address
301 Mariarden Rd
Ste D
Dadeville, AL 36853-0129
Phone
(256) 825-7871
Fax
(256) 825-5742
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19640 AL Primary

Addresses

Primary practice location

301 Mariarden Rd
Ste D
Dadeville, AL 36853-0129

Mailing address

PO Box 129
Dadeville, AL 36853-0129
Phone (256) 825-7871

Other identifiers 1

IdentifierTypeStateIssuer
543420001MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031112000675 AL Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 7810800091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ivy Creek of Tallapoosa LLC 13 clinicians

Practice addresses (Care Compare)

201 Mariarden Rd
Dadeville, AL 36853-6244
Phone (256) 825-7821

201 Mariarden Rd
Dadeville, AL 36853-6245

301 Mariarden Rd
Dadeville, AL 36853-6245
Phone (256) 825-7871

Hospital & facility affiliations

  • Lake Martin Home Health Home health agency, Dadeville, AL, CCN 017117
  • Ivy Creek Hospice Hospice, Dadeville, AL, CCN 011621
  • Lake Martin Community Hospital Hospital, Dadeville, AL, CCN 010052
  • The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029
  • Russell Medical Center Hospital, Alexander City, AL, CCN 010065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19640ALMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivy Creek Family Care of Lake Martin CurrentSince Mar 1, 2023 Accepting new patients
Ivy Creek of Tallapoosa LLC Current Accepting new patients
Ivy Creek of Tallapoosa, LLC Past Accepting new patients

Locations

301 Mariarden Rd
Ste D
Dadeville, AL 36853
Phone (256) 825-7871

301 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-7871

201 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-0677

Interoperability endpoints

  • Direct secure messaging: john.durant@lmf.direct.medconnecthealth.com
  • Direct secure messaging: john.durant@lmfmed.direct.medconnect-inc.com

Organizations & group practices 5

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 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1790717858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368530129",
            "telephone_number": "256-825-7871",
            "fax_number": "256-825-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MARIARDEN RD",
            "address_2": "STE D",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368530129",
            "telephone_number": "256-825-7871",
            "fax_number": "256-825-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURANT",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "19640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543420001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dadeville, AL

Sources for this page

Verify at the official NPI Registry.