Katy J Vanderwal

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

0313 Issued in SD

Practice address

300 22ND Ave
Brookings, SD 57006-2480

Phone

(605) 696-9000

Fax

(605) 696-7758

NPI assigned

Nov 13, 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

Enrolled in SD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• City of Brookings

  • Anesthesiology Physician
  • Brookings, SD
  • NPI 1932281029

  SD

  Medicare reassignment NPD
• City of Brookings

  • Multi-Specialty Clinic/Center
  • Brookings, SD
  • NPI 1134558158
  NPD
• City of Brookings

  • Rural Health Clinic/Center
  • Arlington, SD
  • NPI 1902123581
  NPD
• City of Brookings

  • Rural Health Clinic/Center
  • White, SD
  • NPI 1912279829
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1376614958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWAL",
        "first_name": "KATY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SD",
            "license": "0313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Retirement Center
• Hillary Van Dyke
• Gary Cornelius Van Riper, R.PH
• Rebecca Vande Kop, MD
• Linda K Vande Weerd
• Abigail Joy Vanliere, DDS
• Richard A. Wake, MD
• Victoria Wakeman, BS, CD, LCCE
• Wal-Mart Stores, Inc.
• Marjorie Walberg

• All providers in Brookings, SD
• Registered Dietitian in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.