Lori Lynn Vanderweele, RD, CSP

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

912475 Issued in MI

Practice address

435 Ionia Ave SW Ste A210
Grand Rapids, MI 49503-5161

Phone

(616) 486-0385

NPI assigned

Nov 14, 2011

Last updated

Sep 6, 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 3

Addresses

Other names 1

• Lori L Walters Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1154608578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "269-760-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 IONIA AVE SW STE A210",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035161",
            "telephone_number": "616-486-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWEELE",
        "first_name": "LORI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RD, CSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "912475",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IN",
            "license": "912475",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "912475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "WALTERS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynn Marie Vanderwal, LMSW
• Mary Vanderwal, COTAL, DOR
• David Arthur Vanderwall, M.D.
• Jennifer Vanderwall, PA-C
• Nathan Vanderwall
• Clara Vanderweide
• Kathryn Vanderweide, LMSW
• Samuel David Vanderweide, FNP-C
• Mary Vanderwerp, PA
• Kelsey Jean Vanderwiere, CPNP-AC

• Registered Dietitian in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.