MS. KIMBERLY G WALLANDER R.D.
NPI 1891197711
Dietitian, Registered in East Providence, RI

Q: What is Kimberly Wallander's NPI number?

The NPI number for Kimberly Wallander is 1891197711. It was assigned to this individual provider in the NPPES registry on September 23, 2014. The provider is also known as Kimberly A Gustafson R.D..

Q: What is Kimberly Wallander's specialty?

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

Active since September 23, 2014Accepts Medicare Assignment

450 VETERANS MEMORIAL PKWY STE 8C, EAST PROVIDENCE, RI 02914(401) 396-9331(401) 396-9369 Get Directions Write a Review

NPPES record last updated: July 8, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Ms. Kimberly G Wallander R.d. NPPES

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

MS. KIMBERLY G WALLANDER R.D. (NPI 1891197711) is an individual dietitian, registered in East Providence, Rhode Island, licensed in Rhode Island (LDN00797) and active in the NPI registry since September 2014. She is a graduate of Other (2013).

NPPES Registry Identity

NPI1891197711

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameMS. KIMBERLY G WALLANDERCredential: R.D.

Location Address450 VETERANS MEMORIAL PKWY STE 8CEast Providence, RI 02914-5300

Mailing Address450 Veterans Memorial Pkwy Ste 8cEast Providence, RI 02914-5300 · (401) 396-9331 · Fax (401) 396-9369

Phone(401) 396-9331

Fax(401) 396-9369

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateSeptember 23, 2014

Last NPPES UpdateJuly 8, 2016

✔ NPI 1891197711 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 RI · LDN00797

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.

450 VETERANS MEMORIAL PKWY STE 8C, East Providence, RI 02914

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Other Names 1

Former Name (1)Kimberly A Gustafson R.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kimberly G Wallander R.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456673151

PECOS Enrollment IDI20141209000467

Medicare Billing Reassignment

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

Evolution Nutrition Inc.

Same address

Dietitian, Registered

450 VETERANS MEMORIAL PKWY, SUITE 8C
East Providence, RI 02914

Reassigned Medicare billing, Rhode Island enrollment
29 clinicians in this Medicare group

NPI 1336265800 (401) 396-9331

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02914 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $58.57 – $177.03

Typical copayment $0.00 (range $14.64 – $44.25)

Most-billed visit code NA

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

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

MRS. EMILY SNOW DELCONTE RD

Dietitian, Registered