Elderberry Health Foundation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELDERBERRY HEALTH FOUNDATION

Doing business as

ElderberryMD

Practice address

1207 Delaware Ave #1904
Wilmington, DE 19806

Phone

(314) 788-4620

NPI assigned

Jan 23, 2023

Last updated

Jan 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Landon Wiedenman

Title

Ceo

Phone

(314) 788-4620

Specialties & licenses 1

Addresses

Other names 1

• ElderberryMD Doing business as

Locations

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1376258467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15455 MANCHESTER RD #3313",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630225049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 DELAWARE AVE #1904",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19806",
            "telephone_number": "314-788-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERBERRY HEALTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "WIEDENMAN",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-788-4620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ElderberryMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Eisley, CCC SLP
• Fam Ekladious
• Kathryn Sweeney El-Amraoui, MD
• Amanda El-Chaar, CRNA
• Lauryn Nicole Elder, BCBA
• Eldercare Molter Associates Inc
• Elderly Comfort Corporation
• Elderly Comfort LLC (Comfort Services)
• Colby Eldridge
• Justin P. Eldridge, M.D.

• Family Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.