Individual provider Active NPI

Yee Von Gan

  • Registered Dietitian
  • Silver Spring, MD
National Provider Identifier
1659758936
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
008260-1 Issued in NY
Practice address
10301 Georgia Ave Ste 106
Silver Spring, MD 20902-5020
Phone
(301) 990-1664
Fax
(301) 990-0471
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 008260-1 NY Primary

Addresses

Primary practice location

10301 Georgia Ave Ste 106
Silver Spring, MD 20902-5020

Mailing address

10301 Georgia Ave Ste 106
Silver Spring, MD 20902-5020
Phone (301) 990-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221019001909 DC Practitioner - Registered Dietitian Or Nutrition Professional 3274909064 Reassigns benefits to 1 organization
I20221020002884 VA Practitioner - Registered Dietitian Or Nutrition Professional 3274909064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008260-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 15, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 15, 2022 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

688 Berkmar Cir
Charlottesville, VA 22901

3903 Fair Ridge Dr
Ste 209
Fairfax, VA 22033
Phone (571) 349-2191

8644 Sudley Rd
#220
Manassas, VA 20110

14010 Smoketown Rd
Ste 105
Woodbridge, VA 22192
Phone (703) 730-4848

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: yeevon.gan.1@8042.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1659758936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE STE 106",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "301-990-1664",
            "fax_number": "301-990-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE STE 106",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "301-990-1664",
            "fax_number": "301-990-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAN",
        "first_name": "YEE VON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008260-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.