Individual provider Active NPI

William W McDaniel, MD

  • Psychiatry Physician
  • Norfolk, VA
National Provider Identifier
1205803467
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101038058 Issued in VA
Practice address
825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914
Phone
(757) 446-5888
Fax
(757) 446-5918
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101038058 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Suite 710
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5888

Other identifiers 3

IdentifierTypeStateIssuer
O-80125OtherVASENTARA
326492OtherVAANTHEM
690569TMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20131207000244 VA Order and Referring Only - PsychiatryPractitioner - Psychiatry 2163659673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101038058VAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1205803467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5888",
            "fax_number": "757-446-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 710",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5888",
            "fax_number": "757-446-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101038058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "O-80125",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "326492",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690569T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.