Active NPI
Conrad Henry Daum, MD
- Psychiatry Physician
- Radford, VA
National Provider Identifier
1922093905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101023841
- Practice address
- 401 W Main St
Radford, VA 24141-1588 - Phone
- (540) 838-8000
- Fax
- (540) 982-1116
- NPI assigned
- Sep 15, 2005
- Last updated
- Feb 13, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101023841 | VA | Primary |
Addresses
Primary practice location
401 W Main St
Radford, VA 24141-1588
Mailing address
PO Box 8994
Roanoke, VA 24014-0776
Phone (540) 982-5603
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945221 | Medicaid | VA | |
| 0101023841 | Other | VA | BOARD OF MEDICINE |
| 7165340 | Medicaid | VA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ann E Hedberg MD PLC | Psychiatry | Past | Accepting new patients |
| Conrad H Daum MD PC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Salem, VA
- NPI 1962628883
-
- Psychiatry Physician
- Roanoke, VA
- NPI 1194805804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581552000000",
"number": "1922093905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8994",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240140776",
"telephone_number": "540-982-5603",
"fax_number": "540-982-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W MAIN ST",
"city": "RADFORD",
"state": "VA",
"postal_code": "241411588",
"telephone_number": "540-838-8000",
"fax_number": "540-982-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUM",
"first_name": "CONRAD",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2020-02-13",
"certification_date": "2020-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101023841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004945221",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF MEDICINE",
"identifier": "0101023841",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7165340",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Radford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.