MS. DESIREE ETTALEE VAN DYNE (NPI# 1528343613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528343613 |
| Entity Type | Individual |
| Full Name | MS. DESIREE ETTALEE VAN DYNE |
| Credential | PA |
| Practice Address |
3535 Olentangy River Rd Columbus OH 43214-3908 |
| Mailing Address |
5450 Frantz Rd Ste 360 Dublin OH 43016-4141 |
| Practice Telephone | 6145665283 |
| Practice Fax Number | 6145663638 |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2019-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50.003418 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3535 OLENTANGY RIVER RD |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43214-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710980891 | Amy D Miracle | Advanced Practice Midwife | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2005-05-23 |
| 1295333102 | Amanda Rupert | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-10-13 |
| 1083228159 | Laura Rae Skirtich | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-09-04 |
| 1285247460 | Brittany Nicole Bourne | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-08-26 |
| 1356954614 | Patrick Christopher Hartnett | Nurse Practitioner | 3535 Olentangy River Rd, Columbus, OH 43214-3998 | 2020-08-26 |
| 1235741380 | Kathryn E Mckinnon | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-08-20 |
| 1083226393 | Brittany Vonau | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-08-18 |
| 1487279196 | Joseph Gene Lucas | Nurse Practitioner | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-06-09 |
| 1639793961 | Jordan Vance Dewitt | Pharmacist | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-06-02 |
| 1154944239 | Javahn Lamar Iverson | Specialist/Technologist, Other | 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 2020-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145070 | The Smile Method LLC | Dentist | 3545 Olentangy River Rd., Suite 128, Columbus, OH 43214 | 2020-08-21 |
| 1083175681 | Mahima Venkatesh Prasad | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Road Ground/yellow, Columbus, OH 43214 | 2019-03-27 |
| 1346737988 | Julie Jackson | Occupational Therapist | 214 Westwood Rd, Columbus, OH 43214 | 2018-04-19 |
| 1942703830 | A1 Nursing Solution,llc | Nursing Care | 4770 Indianola Ave Ste Ll-j, Columbus, OH 43214 | 2018-03-16 |
| 1699280024 | Darlene R Britford | Social Worker | 3770 N. High Street, Columbus, OH 43214 | 2017-12-07 |
| 1194235739 | Molly Luckner | Social Worker | 3763 N High St., Ste A, Columbus, OH 43214 | 2017-10-10 |
| 1700395357 | Deidre Monique Radford | Peer Specialist | 3770 North High St., Columbus, OH 43214 | 2017-09-27 |
| 1154844884 | Beth Balog | Pharmacist | 513 Arden Rd, Columbus, OH 43214 | 2017-07-25 |
| 1164951430 | Raad Bin Zakir Chowdhury | Student in an Organized Health Care Education/Training Program | 3595 Olentangy River Road, Columbus, OH 43214 | 2017-06-08 |
| 1841734787 | Joel Franck | Counselor | 3620 High Street, Suite 107, Columbus, OH 43214 | 2016-12-12 |
| Find all providers in zip 43214 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941603 | Ingrid Mompoint-butler | Physician Assistant | 1911 Oakland Park Ave, Columbus, OH 43224-3630 | 2020-10-27 |
| 1649886557 | Justin Knox | Physician Assistant | 7416 Roslindale Dr, Columbus, OH 43235-8904 | 2020-09-17 |
| 1336766310 | Mckenna Marie Wilson | Physician Assistant | 4752 Bentham Dr, Columbus, OH 43220-3204 | 2020-06-25 |
| 1881226744 | Adrian Gorzitze-maxey | Physician Assistant | 117 W Como Ave, Columbus, OH 43202-1027 | 2020-02-09 |
| 1699316604 | James Rodeman | Physician Assistant | 1351 Wyandotte Rd, Columbus, OH 43212-3248 | 2019-10-01 |
| 1740830017 | Rylie Taylor Ingham | Physician Assistant | 285 E State St Ste 600, Columbus, OH 43215-4329 | 2019-09-18 |
| 1487201976 | Columbus Surgical Assist, LLC | Physician Assistant | 605 N. High Street #234, Columbus, OH 43215-2024 | 2019-08-20 |
| 1699237743 | Stefan Khensouri | Physician Assistant | 3375 Paddington Dr, Columbus, IN 47203-4328 | 2019-04-05 |
| 1932681715 | Michael Kenneth Johnson | Physician Assistant | 5399 Coachman Rd Apt E, Columbus, OH 43220-6270 | 2018-08-29 |
| 1760972426 | Simon Nke Acha | Physician Assistant | 285 E State St Ste 360, Columbus, OH 43215-4357 | 2018-05-17 |
| Find all providers in COLUMBUS | ||||
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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.