Individual provider Active NPI

Edward Benjamin Radden III, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Washington, DC
National Provider Identifier
1669637435
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
D0066914 Issued in MD
Practice address
DC Vamc 50 Irving Street
Washington, DC 20042-0001
Phone
(202) 745-8308
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X D0066914 MD Primary

Addresses

Primary practice location

DC Vamc 50 Irving Street
Washington, DC 20042-0001

Mailing address

6909 Laurel Ave # 5682
Takoma Park, MD 20912-4462
Phone (410) 206-4263

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0066914MDMDAddiction Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1669637435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 LAUREL AVE # 5682",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124462",
            "telephone_number": "410-206-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DC VAMC 50 IRVING STREET",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200420001",
            "telephone_number": "202-745-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADDEN",
        "first_name": "EDWARD",
        "middle_name": "BENJAMIN",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MD",
            "license": "D0066914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.