Active NPI
Madalyn Leigh Van Valkenburg, PHARMD
- Pharmacist
- Hattiesburg, MS
National Provider Identifier
1215411558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD14520
- Practice address
- 6051 U S Highway 49
Hattiesburg, MS 39401-7201 - Phone
- (601) 288-7000
- Fax
- (601) 288-4163
- NPI assigned
- Sep 22, 2018
- Sex
- Female
- 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 | PD14520 | AR | Primary |
Addresses
Primary practice location
6051 U S Highway 49
Hattiesburg, MS 39401-7201
Mailing address
906 Corinne St
Hattiesburg, MS 39401-4251
Phone (501) 772-8140
Other practice location 1
1500 E Woodrow Wilson Ave # 119
Jackson, MS 39216-5116
Phone (601) 364-1309 ext. 55329
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD14520 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1215411558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 CORINNE ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394014251",
"telephone_number": "501-772-8140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6051 U S HIGHWAY 49",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017201",
"telephone_number": "601-288-7000",
"fax_number": "601-288-4163"
}
],
"practiceLocations": [
{
"address_1": "1500 E Woodrow Wilson Ave # 119",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392165116",
"country_code": "US",
"telephone_number": "601-364-1309 x55329",
"fax_number": "601-929-2523",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN VALKENBURG",
"first_name": "MADALYN",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-22",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD14520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.