Lucille Yurko Vanderwoude, DNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704318801 Issued in MI

Practice address

2100 Raybrook St SE Ste 100
Grand Rapids, MI 49546-5782

Phone

(616) 235-5101

NPI assigned

Aug 31, 2020

Last updated

Feb 15, 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 2

Addresses

Other names 1

• Lucille Marie Yurko 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Faith HospiceGroup PAC ID 9436102845, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lucille.vanderwoude.1@16329.direct.athenahealth.com

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.

• Faith Hospice

  dba Hospice of Holland Home and Faith Hospice at Trillium Woods

  • Community Based Hospice Care Agency
  • Byron Center, MI
  • NPI 1790739282
  Medicare reassignment Care Compare group NPD
• Faith Palliative Care

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Rapids, MI
  • NPI 1497014476
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Metropolitan Hospital

  dba Metro Health Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1568075364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8214 PFEIFFER FARMS DR SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465782",
            "telephone_number": "616-235-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWOUDE",
        "first_name": "LUCILLE",
        "middle_name": "YURKO",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704318801",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704318801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCILLE",
            "last_name": "YURKO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Anne Vanderwilp, PA-C
• Carissa Johanna Vanderwoude, FNP
• Joshua Samuel Vanderwoude
• Julie Anne Vanderwoude
• Kyle Vanderwoude, DPT
• Samuel Vanderwoude
• Alicia Ann Vanderzanden, AUD
• Jamie Elise Vanderzwaag, LLMSW
• Leah Hope Vanderzwaag, RN BSN
• Melissa Jeanne Vanderzyden, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.
• 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.