MRS. ANNETTE VAN DAM (APRN) – Adult Medicine Physician, NPI 1376914192
Adult Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. ANNETTE VAN DAM (APRN)
796 Ninevah Rd
Frankfort, KY 406017960
Phone: (606) 215-0525
Fax: (606) 283-8253
Type: Location
39 VICKY WAY
FRANKFORT, KY 40601
Phone: (606) 215-0525
Type: Mailing
312 S 4th St Ste 700
Louisville, KY 402023046
Phone: (888) 731-8994
Fax: (623) 999-1761
Type: Location
796 NINEVAH RD
FRANKFORT, KY 406017960
Phone: (888) 731-8994
Fax: (833) 755-1861
Type: Mailing
21 E. STATE ST. OFFICE 233 COLUMBUS, OH 43215
OFFIXE 233
COLUMBUS, OH 43215
Phone: (888) 731-8994
Fax: (623) 999-1761
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-12-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151218000444 | I | Nurse Practitioner | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 221 | 116 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 85 | 82 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 60 | 39 | $0 |
Insurance plans in this area (ZIP 40601)
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