Active NPI
Bailey Daum
- Family Nurse Practitioner
- New Haven, CT
National Provider Identifier
1003568205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10338
- Practice address
- 40 Trumbull St
New Haven, CT 06510-1001 - Phone
- (646) 270-4857
- NPI assigned
- Jan 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10338 | CT | Primary |
Addresses
Primary practice location
40 Trumbull St
New Haven, CT 06510-1001
Mailing address
40 Trumbull St
New Haven, CT 06510-1001
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | baileydaum@mgh.harvard.edu | Massachusetts General Hospital |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10338 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1003568205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 TRUMBULL ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065101001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 TRUMBULL ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065101001",
"telephone_number": "646-270-4857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUM",
"first_name": "BAILEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-19",
"last_updated": "2022-01-19",
"certification_date": "2021-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "10338",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "baileydaum@mgh.harvard.edu",
"affiliation": "Y",
"affiliationName": "Massachusetts General Hospital",
"address_1": "55 Fruit St",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "021142621",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.