Active NPI
Alexis Vandewalle
- Peer Specialist
- Grand Island, NE
National Provider Identifier
1336091412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CPSS-335
- Practice address
- 111 Public Safety Dr
Grand Island, NE 68801-8510 - Phone
- (308) 223-0679
- NPI assigned
- Feb 11, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CPSS-335 | NE | Primary |
Addresses
Primary practice location
111 Public Safety Dr
Grand Island, NE 68801-8510
Mailing address
PO Box 3
Cedar Rapids, NE 68627-0003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPSS-335 | NE | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1336091412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3",
"city": "CEDAR RAPIDS",
"state": "NE",
"postal_code": "686270003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 PUBLIC SAFETY DR",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688018510",
"telephone_number": "308-223-0679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEWALLE",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-11",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NE",
"license": "CPSS-335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.