MS. CALLI JEAN VAN DAM (NPI# 1205201035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205201035 |
| Entity Type | Individual |
| Full Name | MS. CALLI JEAN VAN DAM |
| Credential | AGPCNP |
| Practice Address |
10215 Fernwood Rd Ste 506 Bethesda MD 20817-1184 |
| Practice Telephone | 3015301010 |
| Practice Fax Number | 3018978597 |
| Mailing Telephone | 3015301010 |
| Mailing Fax Number | 3018978597 |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2019-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN1032619 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | LICENSE | AC002241 | 01 |
| VA | LICENSE | 0024175551 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2150 Pennsylvania Ave Nw, Washington, DC 200373201 | 2027413300 |
| Street Address |
10215 FERNWOOD RD STE 506 |
| City | BETHESDA |
| State | MD |
| Zip Code | 20817-1184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134560 | Christopher Cannova | Specialist | 10215 Fernwood Rd, Ste 506, Bethesda, MD 20817-1184 | 2005-06-14 |
| 1154854545 | Susannah Lin Edwards | Dietitian, Registered | 10215 Fernwood Rd, Suite 630, Bethesda, MD 20817-1106 | 2017-04-04 |
| 1194273052 | Margarita E Matamoros | Social Worker | 10215 Fernwood Rd, Ste 630, Bethesda, MD 20817-1106 | 2016-09-20 |
| 1528419397 | Judith W Libert | Social Worker | 10215 Fernwood Rd, Suite 630, Bethesda, MD 20817-1106 | 2016-06-23 |
| 1295190759 | Bethesda Foot & Ankle Center | Podiatrist | 10215 Fernwood Rd, Suite 635, Bethesda, MD 20817-1106 | 2015-12-28 |
| 1992105050 | Rahat Sood | Dentist | 10215 Fernwood Rd, Suite 415, Bethesda, MD 20817-1106 | 2014-08-26 |
| 1841632650 | Michael Jay Tanenhaus | Dentist | 10215 Fernwood Rd, Suite 414, Bethesda, MD 20817-1106 | 2013-07-22 |
| 1396188579 | Center for Continence and Pelvic Support PC | Specialist | 10215 Fernwood Rd, Ste 300, Bethesda, MD 20817-1106 | 2013-04-08 |
| 1326383019 | Jessica L Murgueytio | Dietitian, Registered | 10215 Fernwood Rd, Ste 50, Bethesda, MD 20817-1106 | 2012-12-06 |
| 1831452135 | Ortho-trauma Bethesda, LLC | Orthopaedic Surgery | 10215 Fernwood Rd, Suite 506, Bethesda, MD 20817-1106 | 2012-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135291 | Super Smile Center of Bethesda | Dentist | 10320 Westlake Dr., Suite# 109, Bethesda, MD 20817 | 2020-02-05 |
| 1659918175 | Morgan Cheatham | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd, Suite 300, Bethesda, MD 20817 | 2019-12-03 |
| 1780233601 | Natalie Milazzo | Behavior Technician | Attattn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-09-04 |
| 1366090649 | Sarah Danko | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-29 |
| 1679120760 | Markita Mccurdy | Behavior Technician | 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-22 |
| 1548716277 | Roberta Glass | Psychiatry & Neurology | 9806 Marquette Dr., Bethesda, MD 20817 | 2016-09-01 |
| 1952725525 | Jenna Kuhn | Student in an Organized Health Care Education/Training Program | 6701 Democracy Blvd. Attn: Behavioral Health Works, Suite 300, Bethesda, MD 20817 | 2014-02-18 |
| 1912338088 | Nayereh Nina Ghamarian | Dentist | 6017 Bradley Blvd, Bethesda, MD 20817 | 2013-11-27 |
| 1386076495 | Hugo Galindo | Physical Therapist | 6410 Rockledge Drive, Suite 100, Nrh Rehabilitation Network Bethesda, Bethesda, MD 20817 | 2013-07-31 |
| 1538509260 | Anameti Usoro | Anesthesiology | 6430 Rockledge Dr Ste 160, Bethesda, MD 20817 | 2013-06-26 |
| Find all providers in zip 20817 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961250 | Cassandra Jordan Holmes | Nurse Practitioner | 10 Center Drive Lcim Niaid Nih, Bethesda, MD 20892-0001 | 2020-10-30 |
| 1568748564 | Margaret Sullivan Whelpley | Nurse Practitioner | 10 Center Drive Bldg 10-crc Rm 5-1462, Bethesda, MD 20892 | 2011-10-24 |
| 1457630774 | Shelly R Smith | Nurse Practitioner | 9000 Rockville Pike Nih Bldg 10 Rm 3n 210, Bethesda, MD 20892-0001 | 2011-08-04 |
| 1780838078 | Meghan Clay Punda | Nurse Practitioner | 6410 Rockledge Dr Ste 660, Bethesda, MD 20817-1915 | 2008-11-12 |
| 1255582953 | Kathie Crissey Bronson | Nurse Practitioner | National Institutes of Health Bldg 10 Rm 1c550, 10 Center Dr, Bethesda, MD 20892-0001 | 2008-10-01 |
| 1265507107 | Anna Maria Sam | Nurse Practitioner | 6700 Wisconsin Ave, Minuteclinic LLC, Bethesda, MD 20815-5302 | 2006-11-22 |
| 1427147057 | Amanda Sue Bridges | Nurse Practitioner | 5413w Cedar Ln 203c, Bethesda, MD 20814-1527 | 2006-10-12 |
| 1649200825 | Wendy Wang De Silva | Nurse Practitioner | 7758 Wisconsin Ave, Suite 211, Bethesda, MD 20814-3530 | 2006-07-04 |
| 1467051409 | Ggskinlaserhair | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2020-10-21 |
| 1427676717 | Lindsay Czajkowski | Nurse Practitioner | 9000 Rockville Pike, Bethesda, MD 20892-0003 | 2020-07-13 |
| Find all providers in BETHESDA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.