Miles Durham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

KYPA495 Issued in KY

Practice address

105 Keeton Dr
Hopkinsville, KY 42240-8756

Phone

(270) 889-0701

NPI assigned

Aug 5, 2016

Last updated

Jun 10, 2020By 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 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Kentucky College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennie Stuart Medical Center IncGroup PAC ID 4183607252, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Medicare reassignment Care Compare group
• Jennie Stuart Medical Center Inc

  dba Jennie Stuart Family Health

  • Rural Health Clinic/Center
  • Hopkinsville, KY
  • NPI 1912627605
  NPD
• Jennie Stuart Medical Center

  dba Jennie Stuart Medical Center Home Health

  • Home Health Agency
  • Hopkinsville, KY
  • NPI 1538222500
  NPD (past)
• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Care Compare affiliation

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1841744018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KEETON DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KEETON DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408756",
            "telephone_number": "270-889-0701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10755 Eagle Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422408742",
            "country_code": "US",
            "telephone_number": "270-889-0701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "MILES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-05",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "KYPA495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100434950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Nechole Duncan
• Kelsea Duncan, APRN
• William Patrick Durchholz
• David Durham
• James-Michael Wayne Durham, PHARMD
• Emma Hazel Dusanek
• Dva Renal Healthcare Inc (Christian County Dialysis)
• Dva Renal Healthcare Inc (Hopkinsville Dialysis)
• Donna B Dyer, DPH
• Lauren Kyle Eaker, MSN, AGPCNP-BC

• Physician Assistant in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.