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MRS. ANNETTE VAN DAM APRN
NPI 1376914192
Family Medicine - Adult Medicine in Columbus, OH

Active since October 20, 2015PECOS Enrolled
21 E. STATE ST. OFFICE 233 COLUMBUS, OH 43215, OFFIXE 233, COLUMBUS, OH 43215(888) 731-8994(623) 999-1761 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 23, 2026, Apr 6, 2026, Sep 17, 2025 and 1 more (4 updates tracked since 2025).

About Mrs. Annette Van Dam Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ANNETTE VAN DAM APRN (NPI 1376914192) is an individual adult medicine provider in Columbus, Ohio, licensed in Kentucky (3009783) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1376914192
Entity TypeIndividualFemale
Primary Taxonomy207QA0505X
Provider Legal NameMRS. ANNETTE VAN DAMCredential: APRN
Location Address21 E. STATE ST. OFFICE 233 COLUMBUS, OH 43215, OFFIXE 233Columbus, OH 43215
Mailing Address796 Ninevah RdFrankfort, KY 40601-7960 · (888) 731-8994 · Fax (833) 755-1861
Phone(888) 731-8994
Fax(623) 999-1761
Sole ProprietorNo
Enumeration DateOctober 20, 2015
Last NPPES UpdateApril 23, 20264 updates tracked since enumeration
NPPES CertifiedApril 23, 2026
✔ NPI 1376914192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in KY · 3009783
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedIntegrative MedicineTaxonomy 202D00000X · License 3009783 (KY)
Also ListedGeneral PracticeTaxonomy 208D00000X · License 3009783 (KY)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 3009783 (KY)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 3009783 (KY)
21 E. STATE ST. OFFICE 233 COLUMBUS, OH 43215, Columbus, OH 43215
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Other Names 1

Former Name (1)Annette David Aprn

Secondary Practice Locations 2

Location 1796 Ninevah RdFrankfort, KY 40601-7960 · Phone (606) 215-0525 · Fax (606) 283-8253
Location 2312 S 4th St Ste 700Louisville, KY 40202-3046 · Phone (888) 731-8994 ext. 18994 · Fax (623) 999-1761

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Annette Van Dam Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Annette Van Dam reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Brock Medical, LLC
207 mi
Nurse Practitioner
1752 HIGHWAY 192 W, SUITE 1
London, KY 40741
  • Reassigned Medicare billing, Kentucky enrollment
  • 362 clinicians in this Medicare group
NPI 1023379815 (606) 330-0055
Concord Medical Group Of Kentucky PLLC
239 mi
Emergency Medicine
1011 OLD HIGHWAY 60
Hardinsburg, KY 40143
  • Reassigned Medicare billing, Kentucky enrollment
  • 182 clinicians in this Medicare group
NPI 1346746385 (270) 756-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
90 services44 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
23 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%270 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Annette Van Dam's NPI number?

The NPI number for Annette Van Dam is 1376914192. It was assigned to this individual provider in the NPPES registry on October 20, 2015. The provider is also known as Annette David Aprn.

Where is Annette Van Dam located?

Annette Van Dam practices at 21 E. State St. Office 233 Columbus, Oh 43215 Offixe 233, Columbus, OH 43215. The listed phone number is (888) 731-8994.

What is Annette Van Dam's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Annette Van Dam enrolled in Medicare?

Yes. Annette Van Dam is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Annette Van Dam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Annette Van Dam reassigns Medicare benefits to 2 organizations: Brock Medical, LLC (London, KY) and Concord Medical Group Of Kentucky PLLC (Hardinsburg, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Annette Van Dam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Annette Van Dam was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.