Desiree De Waal, R.D.

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

074-0000171 Issued in VT

Practice address

1 S Prospect St
Uhc Arnold 2318, Renal Clinic
Burlington, VT 05401-3456

Phone

(802) 847-3203

Fax

(802) 847-3607

NPI assigned

Oct 3, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003900358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "address_2": "UHC ARNOLD 2318, RENAL CLINIC",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-3203",
            "fax_number": "802-847-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "address_2": "UHC ARNOLD 2318, RENAL CLINIC",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-3203",
            "fax_number": "802-847-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE WAAL",
        "first_name": "DESIREE",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "VT",
            "license": "074-0000171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine A Dawber, PA-C
• Alexander Rhea Dawson, M.D.
• Dawnaly Dax, RN
• Chelsea Day, LICSW
• Emily R Day, DPT
• Jaime Deacon, BCBA
• Justin A. Deangelis, M.D.
• Julie L. Debacker, M.D.
• James Philip Debay, P.A.
• Jennifer Debedout, MM, MT-BC

• All providers in Burlington, VT
• Renal Nutrition Registered Dietitian in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.