Individual provider Active NPI

Rebekah R Vandewalle, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1770030157
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7128-33 Issued in WI
Practice address
725 S Webster Ave
Green Bay, WI 54301-3500
Phone
(920) 430-7100
Fax
(920) 430-7114
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7128-33 WI Primary

Addresses

Primary practice location

725 S Webster Ave
Green Bay, WI 54301-3500

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone (920) 430-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20161004001533 WI Practitioner - Nurse Practitioner 2163710302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

725 S Webster Ave
Suite 201
Green Bay, WI 54301-3500
Phone (920) 430-7100

744 S Webster Ave
Green Bay, WI 54301-3505

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Sep 20, 2016 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Sep 20, 2016 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

725 S Webster Ave
Ste 201
Green Bay, WI 54301
Phone (920) 430-1700

725 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-7995

107 E Highland Dr
Oconto Falls, WI 54154
Phone (920) 846-0509

Interoperability endpoints

  • Direct secure messaging: rvandewalle916375@direct.emplifyhealth.org
  • Direct secure messaging: rvandewalle171660@direct.thedacare.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1770030157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013500",
            "telephone_number": "920-430-7100",
            "fax_number": "920-430-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 E Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541002",
            "country_code": "US",
            "telephone_number": "920-430-7100",
            "fax_number": "920-430-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEWALLE",
        "first_name": "REBEKAH",
        "middle_name": "R",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7128-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.