Individual provider Active NPI

Bryan Vander Linden, PHARMD

  • Pharmacist
  • Fairfield, IA
National Provider Identifier
1023642162
Registry record updated May 14, 2020
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21951 Issued in IA
Practice address
300 W Burlington Ave
Fairfield, IA 52556-3241
Phone
(641) 472-7987
NPI assigned
Feb 27, 2020
Last updated
May 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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. Confirm with the OIG exclusions search.
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21951IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascent Pharmacy of Iowa CurrentSince Jun 23, 2025 Accepting new patients
Summit Pharmacy of Iowa, Inc CurrentSince May 17, 2020 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.

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

Verify at the official NPI Registry.