Judith Rebecca Daumen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9700918 Issued in NC

Practice address

4414 Lake Boone Trail
Suite 103
Raleigh, NC 27607

Phone

(919) 787-0266

Fax

(919) 571-9314

NPI assigned

May 15, 2006

Last updated

Mar 30, 2021By the provider in NPPES

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 2

Other names 1

• Ms. Judith Rebecca Gordon Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HICECA
• Direct secure messaging: r.daumen@wop.eclinicaldirectplus.com
• Direct secure messaging: rebecca.daumen@wop.eclinicaldirectplus.com

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.

• White Oak Pediatric Associates PA

  • Specialist
  • Raleigh, NC
  • NPI 1902953045
  Medicare reassignment NPD
• White Oak Pediatric Associates

  dba White Oak Pediatrics

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1891939286
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1477504272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRAIL",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-787-0266",
            "fax_number": "919-571-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRAIL",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-787-0266",
            "fax_number": "919-571-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUMEN",
        "first_name": "JUDITH",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9700918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "012U3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79012U3",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "r.daumen@wop.eClinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4414 Lake Boone Trail",
            "address_2": "Suite 103",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "GORDON",
            "middle_name": "REBECCA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connor Caroline Daughtridge
• Kelly Daughtridge, MSW, LCSWA
• Taria Daughtridge
• Kayla Daughtry
• Sara Michelle Daum
• Stuti Dave, DPT
• Ashley Parker Davenport, CRNA
• Breanna Davenport
• Elizabeth Shannon Davenport, LCSW
• Heather Michelle Davenport, PT

• Pediatrics Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.