Clara Vanderweide

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704293832 Issued in MI

Practice address

730 Grandville Ave SW
Grand Rapids, MI 49503-4920

Phone

(616) 685-8400

NPI assigned

Jul 7, 2015

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

Other names 1

• Clara Dejonge Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

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.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health/Saint Mary'S Medical Group

  • Clinic/Center
  • Sparta, MI
  • NPI 1760599906
  NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Canton, MI
  • NPI 1134458086
  NPD

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1558744797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GRANDVILLE AVE SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034920",
            "telephone_number": "616-685-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWEIDE",
        "first_name": "CLARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704293832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARA",
            "last_name": "DEJONGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Vanderwal, COTAL, DOR
• David Arthur Vanderwall, M.D.
• Jennifer Vanderwall, PA-C
• Nathan Vanderwall
• Lori Lynn Vanderweele, RD, CSP
• Kathryn Vanderweide, LMSW
• Samuel David Vanderweide, FNP-C
• Mary Vanderwerp, PA
• Kelsey Jean Vanderwiere, CPNP-AC
• Jessica Anne Vanderwilp, PA-C

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.