Active NPI
Madeleine Simone Van Dyke
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Toledo, OH
National Provider Identifier
1538893698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 03442186
- Practice address
- 2244 Collingwood Blvd
Toledo, OH 43620-1147 - Phone
- (567) 318-3891
- NPI assigned
- Jul 14, 2022
- Last updated
- Apr 13, 2023
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 03442186 | OH | Primary |
Addresses
Primary practice location
2244 Collingwood Blvd
Toledo, OH 43620-1147
Mailing address
17870 County Rd S
Alvordton, OH 43501-9743
Other practice location 1
228 S Main St
Bryan, OH 43506-1755
Phone (567) 239-4562
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 |
|---|---|---|---|
| 03442186 | OH | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores, L.L.C. | Past | Accepting new patients | |
| Ohio CVS Stores LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1538893698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17870 COUNTY RD S",
"city": "ALVORDTON",
"state": "OH",
"postal_code": "435019743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2244 COLLINGWOOD BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436201147",
"telephone_number": "567-318-3891"
}
],
"practiceLocations": [
{
"address_1": "228 S Main St",
"address_purpose": "LOCATION",
"city": "Bryan",
"state": "OH",
"postal_code": "435061755",
"country_code": "US",
"telephone_number": "567-239-4562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN DYKE",
"first_name": "MADELEINE",
"middle_name": "SIMONE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-14",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OH",
"license": "03442186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.