Individual provider Active NPI

Linda Joanne Maddaus-White, RPH

  • Pharmacist
  • Edina, MN
National Provider Identifier
1447536354
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
112288-0 Issued in MN
Practice address
5121 Vernon Ave S
Edina, MN 55436-2104
Phone
(952) 920-5899
NPI assigned
Oct 25, 2011
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 112288-0 MN Primary

Addresses

Primary practice location

5121 Vernon Ave S
Edina, MN 55436-2104

Mailing address

5121 Vernon Ave S
Edina, MN 55436-2104
Phone (952) 920-5899

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
112288-0MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1447536354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 VERNON AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362104",
            "telephone_number": "952-920-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 VERNON AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362104",
            "telephone_number": "952-920-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDAUS-WHITE",
        "first_name": "LINDA",
        "middle_name": "JOANNE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "112288-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.