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MRS. KATY J VANDERWAL
NPI 1376614958
Dietitian, Registered in Brookings, SD

Active since November 13, 2006
300 22ND AVE, BROOKINGS, SD 57006(605) 696-9000(605) 696-7758 Get Directions Write a Review

NPPES record last updated: August 11, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Katy J Vanderwal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KATY J VANDERWAL (NPI 1376614958) is an individual dietitian, registered in Brookings, South Dakota, licensed in South Dakota (0313) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1376614958
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMRS. KATY J VANDERWAL
Location Address300 22ND AVEBrookings, SD 57006-2480
Mailing Address300 22nd AveBrookings, SD 57006-2480 · (605) 696-9000 · Fax (605) 696-7758
Phone(605) 696-9000
Fax(605) 696-7758
Sole ProprietorNo
Enumeration DateNovember 13, 2006
Last NPPES UpdateAugust 11, 2009
✔ NPI 1376614958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in SD · 0313
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
300 22ND AVE, Brookings, SD 57006
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Katy J Vanderwal is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Katy Vanderwal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

City Of Brookings
Same address
Anesthesiology
300 22ND AVE
Brookings, SD 57006
  • Reassigned Medicare billing, South Dakota enrollment
  • 156 clinicians in this Medicare group
NPI 1932281029 (606) 696-9000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BROOKINGS HEALTH SYSTEM
General Acute Care Hospital
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
CATHERINE A LEADABRAND MD
Internal Medicine
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-8021
CITY OF BROOKINGS
Nursing Facility/Intermediate Care Facility
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
SHANNON MEDENWALD RD
Dietitian, Registered
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
CITY OF BROOKINGS
General Acute Care Hospital
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
CITY OF BROOKINGS
Hospice Care, Community Based
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
MRS. JADA KAHL MSOTR/L
Occupational Therapist
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000
CITY OF BROOKINGS
Skilled Nursing Facility
300 22ND AVE
BROOKINGS, SD 57006
Brookings County (605) 696-9000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katy Vanderwal's NPI number?

The NPI number for Katy Vanderwal is 1376614958. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Where is Katy Vanderwal located?

Katy Vanderwal practices at 300 22nd Ave, Brookings, SD 57006. The listed phone number is (605) 696-9000.

What is Katy Vanderwal's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Katy Vanderwal enrolled in Medicare?

Yes. Katy Vanderwal is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katy Vanderwal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katy Vanderwal reassigns Medicare benefits to City Of Brookings (Brookings, SD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katy Vanderwal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katy Vanderwal was last updated on August 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.