Active NPI
Madalyn Waldmann, OTRL
- Occupational Therapist
- Golden Valley, MN
National Provider Identifier
1700533460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 106759
- Practice address
- 7505 Country Club Dr
Golden Valley, MN 55427-4501 - Phone
- (763) 450-9600
- NPI assigned
- Mar 3, 2022
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 106759 | MN | Primary |
Addresses
Primary practice location
7505 Country Club Dr
Golden Valley, MN 55427-4501
Mailing address
7505 Country Club Dr
Golden Valley, MN 55427-4501
Other practice location 1
420 Marshall Ave
Saint Paul, MN 55102-1718
Phone (651) 224-2368
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 |
|---|---|---|---|
| 106759 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1700533460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7505 COUNTRY CLUB DR",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7505 COUNTRY CLUB DR",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274501",
"telephone_number": "763-450-9600"
}
],
"practiceLocations": [
{
"address_1": "420 Marshall Ave",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551021718",
"country_code": "US",
"telephone_number": "651-224-2368",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALDMANN",
"first_name": "MADALYN",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-03",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "106759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.