NPIMap

Organization Active NPI

Kathleen Van de Walle DO PC

  • Internal Medicine Physician
  • Aberdeen, SD
National Provider Identifier
1295886307
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0248 Issued in SD
Legal business name
KATHLEEN VAN DE WALLE DO PC
Practice address
1314 N Main St
Aberdeen, SD 57401-2032
Phone
(605) 229-3682
NPI assigned
Jan 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kathleen Van de Walle, D.O.NPI 1952410185
Title
President
Phone
(605) 229-3682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0248 SD Primary

Addresses

Primary practice location

1314 N Main St
Aberdeen, SD 57401-2032

Mailing address

1314 N Main St
Aberdeen, SD 57401-2032
Phone (605) 229-3682

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295886307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 N MAIN ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574012032",
            "telephone_number": "605-229-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N MAIN ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574012032",
            "telephone_number": "605-229-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN VAN DE WALLE DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN DE WALLE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-229-3682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "0248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.