Gavin Van de Walle, MS, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1601 E 77TH St Apt 1428
Sioux Falls, SD 57108-3036

Phone

(605) 323-7222

NPI assigned

Sep 4, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EFIIBD/Endpoint/EFIIBD

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.

• City of Sioux Falls

  • Federally Qualified Health Center (FQHC)
  • Sioux Falls, SD
  • NPI 1609025907
  NPD (past)
• City of Sioux Falls

  • Federally Qualified Health Center (FQHC)
  • Sioux Falls, SD
  • NPI 1932295888
  NPD (past)

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1003398256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571010210",
            "telephone_number": "605-323-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 77TH ST APT 1428",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083036",
            "telephone_number": "605-323-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE WALLE",
        "first_name": "GAVIN",
        "credential": "MS, RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Verle D Valentine, MD
• Erik Valer, RN
• Melinda Valsvig, DNAP
• Laura Jane Van Beek, NP-C
• Stephanie K Van Dam, CNP
• Robert Eugene Van Demark III, MD
• Marah Jo Van Diest, MD
• Lora Lee Van Dyke, PHARM D
• Elizabeth Ann Van Egdom, RD, LN
• Troy Van Essen, PPT

• Registered Dietitian in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Registered Dietitian in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; 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.