Active NPI
Deborah Marie Lindgren-Clendenen, RN, MN, GNP-BC, APNP
- Gerontology Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1790835445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- R1088908
- Practice address
- 800 E 28TH St
H2100
Minneapolis, MN 55407-3723 - Phone
- (612) 863-3900
- Fax
- (612) 863-1681
- NPI assigned
- Jan 12, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 115271-030 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | 4024-033 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | R1088908 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
H2100
Minneapolis, MN 55407-3723
Mailing address
2508 Colfax Ave S
Minneapolis, MN 55405-2946
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2954796-00 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dlindgrenclendenen146005@excellian.direct.allina.com | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115271-030 | WI | MD | Community Health Registered Nurse |
| R1088908 | MN | MD | Gerontology Nurse Practitioner |
| 4024-033 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | Accepting new patients |
Interoperability endpoints
- dlindgrenclendenen146005@excellian.direct.allina.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1790835445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2508 COLFAX AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554052946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"address_2": "H2100",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "612-863-3900",
"fax_number": "612-863-1681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDGREN-CLENDENEN",
"first_name": "DEBORAH",
"middle_name": "MARIE",
"credential": "RN, MN, GNP-BC, APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "WI",
"license": "115271-030",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "4024-033",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "R1088908",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2954796-00",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dlindgrenclendenen146005@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CPA/PDF/TXT",
"address_1": "800 E 28th St",
"address_2": "H2100",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554073723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.