Individual provider Active NPI

Madelyn Speakman, PHARMD

  • Pharmacotherapy Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1366915696
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
26027963A Issued in IN
Practice address
4242 E Dupont Rd
Fort Wayne, IN 46825-1759
Phone
(260) 279-2520
Fax
(260) 279-2545
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 26027963A IN Primary

Addresses

Primary practice location

4242 E Dupont Rd
Fort Wayne, IN 46825-1759

Mailing address

4242 E Dupont Rd
Fort Wayne, IN 46825-1759
Phone (260) 279-2520

Other practice location 1

2990 N Wayne St
Angola, IN 46703-9121
Phone (260) 668-1110

Other practice location 2

6309 Lima Rd
Fort Wayne, IN 46818-1425
Phone (260) 497-1010

Other practice location 3

5909 Illinois Rd
Fort Wayne, IN 46804-1159
Phone (260) 434-3910

Other practice location 4

10301 State Route 37 (Maysville Road)
Fort Wayne, IN 46835
Phone (260) 492-1310

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

LicenseStateTypeSpecialty
26027963AINMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meijer Stores Limited Partnership CurrentSince May 8, 2022 Accepting new patients
Meijer Stores Limited Partnership PastSince May 8, 2022 Accepting new patients

Locations

4242 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 279-2520

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1366915696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251759",
            "telephone_number": "260-279-2520",
            "fax_number": "260-279-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251759",
            "telephone_number": "260-279-2520",
            "fax_number": "260-279-2545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2990 N Wayne St",
            "address_purpose": "LOCATION",
            "city": "Angola",
            "state": "IN",
            "postal_code": "467039121",
            "country_code": "US",
            "telephone_number": "260-668-1110",
            "fax_number": "260-668-1165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6309 Lima Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468181425",
            "country_code": "US",
            "telephone_number": "260-497-1010",
            "fax_number": "260-497-1065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5909 Illinois Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468041159",
            "country_code": "US",
            "telephone_number": "260-434-3910",
            "fax_number": "260-434-3965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10301 State Route 37 (Maysville Road)",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46835",
            "country_code": "US",
            "telephone_number": "260-492-1310",
            "fax_number": "260-492-1365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEAKMAN",
        "first_name": "MADELYN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IN",
            "license": "26027963A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.