Kawanta Foster Durham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

157245 Issued in NC

Practice address

104 Pomona Dr
Greensboro, NC 27407-1616

Phone

(336) 268-4100

Fax

(336) 268-3158

NPI assigned

Jun 4, 2009

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Howard University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdurham1038488@direct.novanthealth.org
• Direct secure messaging: kdurham9897@direct.conehealth.com
• Direct secure messaging: kawanta.durham@eaglep.eclinicaldirectplus.com

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.

• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1720794944
  NPD
• Eagle Physicians and Associates PA

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD
• Novant Health Medical Group, LLC

  • Surgery Physician
  • Winston Salem, NC
  • NPI 1063885614
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Eagle Physicians and Associates PA

  • Primary Care Clinic/Center
  • Greensboro, NC
  • NPI 1184665499
  NPD (past)
• Eagle Physicians and Associates PA

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1396852570
  NPD (past)
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1407871361
  NPD (past)
• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1821224866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 POMONA DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071616",
            "telephone_number": "336-268-4100",
            "fax_number": "336-268-3158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N Church St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011007",
            "country_code": "US",
            "telephone_number": "336-832-7486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4901 E Nc Highway 150",
            "address_purpose": "LOCATION",
            "city": "Browns Summit",
            "state": "NC",
            "postal_code": "272149719",
            "country_code": "US",
            "telephone_number": "336-656-9905",
            "fax_number": "336-656-5277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Highland Oaks Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271037114",
            "country_code": "US",
            "telephone_number": "336-277-4380",
            "fax_number": "336-659-0659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "KAWANTA",
        "middle_name": "FOSTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "157245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdurham9897@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4901 E Nc Highway 150",
            "city": "Browns Summit",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272149719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kawanta.durham@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5921 W Friendly Ave Ste D",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274103268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kawanta.durham@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "104 Pomona Dr",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274071616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Harmonie Janae' Dupree
• Sheritta Dupree
• Tieshia Ann Durant, NP
• Alison Adams Durham, D.P.M
• Christopher L Durham, DDS
• Kenan Durham
• Dwayne'S Extended Family Services, Inc.
• Dwell Ministry PC
• Dynamic Duo Counseling PLLC
• Rachel Dyrhaug, FNP

• Family Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.