Clarisa Dana Quarles-Diallo, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R160007 Issued in MD

Practice address

3195 Old Washington Rd
Waldorf, MD 20602-3201

Phone

(240) 419-3658

NPI assigned

May 18, 2023

Last updated

May 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Arizona College of Medicine - Phoenix, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospice of the Chesapeake, Inc.Group PAC ID 0244202463, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospice of the Chesapeake, Inc

  dba Chesapeake Supportive Care

  • Community Based Hospice Care Agency
  • Pasadena, MD
  • NPI 1750575908

  DC

  Medicare reassignment Care Compare group NPD
• Hospice of the Chesapeake, Inc

  • Community Based Hospice Care Agency
  • Waldorf, MD
  • NPI 1194748558
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1295426252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12811 ASBURY DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207446408",
            "telephone_number": "301-292-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 OLD WASHINGTON RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023201",
            "telephone_number": "240-419-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARLES-DIALLO",
        "first_name": "CLARISA",
        "middle_name": "DANA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R160007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Tomlines Putnam, CRNP
• Pyramid Walden LLC
• Pyramid Walden, LLC
• Qreativ Moodz
• Quality Healthcare Clinics LLC
• Mary B Quarles, LCPC
• Lois Quaye, PHARMD
• Robin Y Queen, MSW, LICSW, LCSW-C
• R.E.a.M LLC (Liberty Advanced Nursing at Home)
• Rachels Hair Loft LLC

• Family Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.