Laurie J Daum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301053702 Issued in MI

Practice address

245 State St SE
Grand Rapids, MI 49503-4348

Phone

(616) 685-8500

Fax

(616) 685-8075

NPI assigned

May 15, 2006

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

Other identifiers 9

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Wayne State University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

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.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment Care Compare group NPD
• Mercy Physician Network

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1023056744
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Mercy Physician Network

  • Family Medicine Physician
  • Fruitport, MI
  • NPI 1639502701
  NPD
• Advantage Health Physicians PC

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1386695252
  NPD (past)
• Saint Mary'S Health Services

  • Anesthesiology Physician
  • Grand Rapids, MI
  • NPI 1124063078
  NPD (past)

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

• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1457302184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034348",
            "telephone_number": "616-685-8500",
            "fax_number": "616-685-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUM",
        "first_name": "LAURIE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301053702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4382109",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4380884",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4878471",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3211260",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4349561",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4349570",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4202560",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4349580",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415582",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldaum26096@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Physician Partners",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "office",
            "address_1": "245 State St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dasco HME, LLC
• Laura A Datema, CNP
• Andrea Joyce Dattadeen, LLPC
• Kimberly Kaye Daugherty, PHARMD
• Alison Dault, LMSW
• Annie Daus, MA, CCC-SLP
• Mackenzie Davenport, AT, ATC
• David Barney PLLC
• David D Brelinski III, PLLC
• David G Frye PC

• Family Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.