Active NPI
Bryan Vander Linden, PHARMD
- Pharmacist
- Fairfield, IA
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Mar 19, 2026.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21951
- Practice address
- 300 W Burlington Ave
Fairfield, IA 52556-3241 - Phone
- (641) 472-7987
- NPI assigned
- Feb 27, 2020
- Last updated
- May 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21951 | IA | Primary |
Addresses
Primary practice location
300 W Burlington Ave
Fairfield, IA 52556-3241
Mailing address
1105 Kodi Cir
Fairfield, IA 52556-3756
Phone (641) 204-1312
Other practice location 1
1300 W Burlington Ave
Fairfield, IA 52556-2766
Phone (641) 472-3542
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21951 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascent Pharmacy of Iowa | Current | Accepting new patients | |
| Summit Pharmacy of Iowa, Inc | Current | Accepting new patients |
Locations
300 W Burlington Ave
Fairfield, IA 52556
Phone (641) 472-7987
Organizations & group practices 2
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.
-
dba Summit Pharmacy
- Community/Retail Pharmacy
- Fairfield, IA
- NPI 1154941870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1023642162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 KODI CIR",
"city": "FAIRFIELD",
"state": "IA",
"postal_code": "525563756",
"telephone_number": "641-204-1312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W BURLINGTON AVE",
"city": "FAIRFIELD",
"state": "IA",
"postal_code": "525563241",
"telephone_number": "641-472-7987"
}
],
"practiceLocations": [
{
"address_1": "1300 W Burlington Ave",
"address_purpose": "LOCATION",
"city": "Fairfield",
"state": "IA",
"postal_code": "525562766",
"country_code": "US",
"telephone_number": "641-472-3542",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDER LINDEN",
"first_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-27",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.