Individual provider Active NPI

Cristin Renae Vander Weerdt, PA-C

  • Surgical Physician Assistant
  • Dakota Dunes, SD
National Provider Identifier
1699938092
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone
(605) 217-2667
Fax
(605) 217-2900
NPI assigned
Jul 7, 2008
Last updated
Sep 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X SD Primary

Addresses

Primary practice location

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312

Mailing address

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA, NE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080904000361 SD Practitioner - Physician Assistant 2769558410 Reassigns benefits to 1 organization
I20080905000071 IA Practitioner - Physician Assistant 2769558410 Reassigns benefits to 2 organizations
I20090403000472 NE Practitioner - Physician Assistant 2769558410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Cnos PCGroup PAC ID 4284548942, 98 clinicians
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

600 N Sioux Point Rd
Dakota Dunes, SD 57049-5000
Phone (605) 232-3332

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1399NEMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Burgess Health Center CurrentSince Jun 1, 2021 Accepting new patients
Burgess Health Center CurrentSince Jun 1, 2021 Accepting new patients
Cnos, PC CurrentSince Jul 17, 2008 Accepting new patients
Cnos PC CurrentSince Jul 17, 2008 Accepting new patients

Locations

1111 11th St
Hawarden, IA 51023
Phone (712) 551-3100

1600 Diamond St
Onawa, IA 51040
Phone (712) 423-2311

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692

201 E 4th St
Ste 202
South Sioux City, NE 68776

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615

Interoperability endpoints

  • Direct secure messaging: cristinvanderweerdt@cnos.allscriptsdirect.net
  • Direct secure messaging: cvanderweerdt128426@direct.unitypoint.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1699938092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER WEERDT",
        "first_name": "CRISTIN",
        "middle_name": "RENAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

Verify at the official NPI Registry.