NPIMap

Organization Active NPI

Damd, Inc

  • Family Nurse Practitioner
  • Berlin, MD
National Provider Identifier
1013010198
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000410 Issued in DE
Legal business name
DAMD, INC
Practice address
331 Buttercup CT
Berlin, MD 21811
Phone
(410) 713-2353
NPI assigned
Sep 6, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Mary Elizabeth Bernal-Clark, APRN,BC
Title
CRNP
Phone
(410) 641-1117

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X LG-0000410 DE Primary

Addresses

NPPES NPI Registry

Primary practice location

331 Buttercup CT
Berlin, MD 21811

Mailing address

P.O. Box 2497
Salisbury, MD 21802-2497
Phone (443) 260-2660

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
405537300MedicaidMD
1000036290MedicaidDE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 17, 2008.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1013010198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2497",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218022497",
            "telephone_number": "443-260-2660",
            "fax_number": "443-260-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 BUTTERCUP CT",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-713-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "BERNAL-CLARK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CRNP",
        "authorized_official_telephone_number": "410-641-1117",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN,BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405537300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000036290",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.