Stephanie Marie Vande Brake, R.D., L.D

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

002142 Issued in IA

Practice address

1914 8TH St
Coralville, IA 52241-1612

Phone

(319) 351-5523

NPI assigned

Apr 15, 2014

Last updated

Aug 5, 2014By 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 1

Addresses

Other names 1

• Stephanie Marie Potratz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hy-Vee Health PC

  • Registered Dietitian
  • Des Moines, IA
  • NPI 1396511226

  Dietitian, Registered

  NPD
• Hy-Vee Health PC

  • Internal Medicine Physician
  • West Des Moines, IA
  • NPI 1558086637
  NPD
• Hy-Vee Health PC

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1184498990
  NPD

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1841619046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 8TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411612",
            "telephone_number": "319-351-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 8TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411612",
            "telephone_number": "319-351-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE BRAKE",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "R.D., L.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "002142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "POTRATZ",
            "middle_name": "MARIE",
            "credential": "R.D., L.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Jo Vahle, LMSW
• Stephanie Lynn Van Housen, LMSW
• Megan Van Laar, M.A., CCC-SLP
• Rachel Nadine Van Wickle, MS TLMFT
• Ashley Vance
• Mariella Ann Vandergaast, RN
• Levi S Vankirk, PHARM.D.
• Abigail Rose Vanpatten-Freeman, TLMHC
• Susan Mortweet Vanscoyoc, PH.D.
• Lisa Marie Vanwiel, PT, DPT

• Registered Dietitian in Coralville, IA
• Providers in Coralville, IA by specialty
• Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.