Heidi Durham, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

194636 Issued in AK

Practice address

3750 E Country Field Cir Ste B
Wasilla, AK 99654-6659

Phone

(907) 373-1410

Fax

(907) 373-1411

NPI assigned

Aug 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Heidi Durham Former name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Nose and Throat Specialists Alaska, IncGroup PAC ID 6204848294, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• Ear, Nose and Throat Specialists Alaska, Inc.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Anchorage, AK
  • NPI 1972552891

  AK

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1831478841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 E COUNTRY FIELD CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546659",
            "telephone_number": "907-373-1410",
            "fax_number": "907-373-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 E COUNTRY FIELD CIR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546659",
            "telephone_number": "907-373-1410",
            "fax_number": "907-373-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "HEIDI",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17785",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "194636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173505",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "DURHAM",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra L. Duncan, CMT, MLD, CDT
• Patrick Allen Dunlap
• Darlene S. Dunn, NP-C, PHD
• Abigail Dupre
• Vanessa Dupree
• Lee Anne Durham
• Seth Dye
• Jennifer Dykstra, REGISTERED NURSE
• Jessie Eakens
• Megan Eakin, DPT, PT

• All providers in Wasilla, AK
• Speech-Language Pathologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.