Individual provider Active NPI

Deborah Marie Lindgren-Clendenen, RN, MN, GNP-BC, APNP

  • Gerontology Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1790835445
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R1088908 Issued in MN
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

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2954796-00MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
115271-030WIMDCommunity Health Registered Nurse
R1088908MNMDGerontology Nurse Practitioner
4024-033WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.