Active NPI
Lindsey Spedevick, RPH
- Pharmacist
- Maplewood, MN
National Provider Identifier
1790310043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123918
- Practice address
- 2196 White Bear Ave N
Maplewood, MN 55109-2708 - Phone
- (651) 704-0322
- Fax
- (651) 704-0328
- NPI assigned
- Mar 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 183500000X | 123918 | MN | Primary |
Addresses
Primary practice location
2196 White Bear Ave N
Maplewood, MN 55109-2708
Mailing address
2196 White Bear Ave N
Maplewood, MN 55109-2708
Phone (651) 704-0322
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
| License | State | Type | Specialty |
|---|---|---|---|
| 123918 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1790310043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2196 WHITE BEAR AVE N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551092708",
"telephone_number": "651-704-0322",
"fax_number": "651-704-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2196 WHITE BEAR AVE N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551092708",
"telephone_number": "651-704-0322",
"fax_number": "651-704-0328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEDEVICK",
"first_name": "LINDSEY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-06",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, MN
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- St. Francis Health Care System Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.