Active NPI
Linda Boller
- Pharmacist
- Indianapolis, IN
National Provider Identifier
1104158344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26017689A
- Practice address
- 2715 Madison Ave
Indianapolis, IN 46225-2112 - Phone
- (317) 784-6831
- Fax
- (317) 783-6043
- NPI assigned
- Feb 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 26017689A | IN | Primary |
Addresses
Primary practice location
2715 Madison Ave
Indianapolis, IN 46225-2112
Mailing address
2715 Madison Ave
Indianapolis, IN 46225-2112
Phone (317) 784-6831
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26017689A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1104158344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2715 MADISON AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462252112",
"telephone_number": "317-784-6831",
"fax_number": "317-783-6043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2715 MADISON AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462252112",
"telephone_number": "317-784-6831",
"fax_number": "317-783-6043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLER",
"first_name": "LINDA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-11",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26017689A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.