Madeline Lea Taitt

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

051037697 Issued in IL

Practice address

3637 Herrin Rd
Carterville, IL 62918-3156

Phone

(618) 687-9454

NPI assigned

Jan 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Murphysboro, IL
  • NPI 1134153943
  NPD (past)
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1629608773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E INDUSTRIAL PARK RD UNIT 1",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663947",
            "telephone_number": "618-687-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 HERRIN RD",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629183156",
            "telephone_number": "618-687-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAITT",
        "first_name": "MADELINE",
        "middle_name": "LEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051037697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaelee Stevens, MSW, LSW
• Alexandra Stromidlo
• Jamie Stuck
• Katie Surman, RD
• Shanda Sylwester, MSW
• Paul A Tart, CPRS
• Emily Taylor
• The H Group BBT, Inc
• TLC Home Care Services, Inc.
• TLC of Southern & Central Illinois Inc.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Carterville, IL
• Providers in Carterville, IL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.