Individual provider Active NPI

Sheryl Dawn Vander Wal, WHCNP

  • Women's Health Clinical Nurse Specialist
  • Austin, TX
National Provider Identifier
1720140742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Clinical Nurse SpecialistTaxonomy code 364SW0102X
License
673129 Issued in TX
Practice address
313 E 12TH St
Ste 104
Austin, TX 78701-1954
Phone
(409) 747-0890
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Clinical Nurse Specialist 364SW0102X 673129 TX Primary

Addresses

Primary practice location

313 E 12TH St
Ste 104
Austin, TX 78701-1954

Mailing address

301 University Blvd
Galveston, TX 77555-1022
Phone (409) 747-0890

Other identifiers 1

IdentifierTypeStateIssuer
174291801MedicaidTX

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Werner Horn Karnik Douglas Hummer PA Past Accepting new patients
Utmb Austin - Initiatives Past Accepting new patients
University of Texas Medical Branch, Austin Initiatives at Utmb Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720140742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551022",
            "telephone_number": "409-747-0890",
            "fax_number": "409-772-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 E 12TH ST",
            "address_2": "STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011954",
            "telephone_number": "409-747-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER WAL",
        "first_name": "SHERYL",
        "middle_name": "DAWN",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "TX",
            "license": "673129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174291801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.