Individual provider Active NPI

Linnea P Linderman, MD

  • Pediatrics Physician
  • Woodbridge, VA
National Provider Identifier
1861492449
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101261526 Issued in VA
Practice address
4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone
(703) 680-7950
Fax
(703) 680-7953
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 194511-1 NY
Pediatrics Physician 208000000X 0101261526 VA Primary

Addresses

Primary practice location

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323

Mailing address

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone (703) 680-7950

Other identifiers 1

IdentifierTypeStateIssuer
01534394MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023001850 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1850667635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
194511-1NYMDPediatrics Physician
0101261526VAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1861492449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "036-807-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDERMAN",
        "first_name": "LINNEA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "194511-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101261526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01534394",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.