Active NPI
Jacqueline Randa
- Attendant Care Provider
- Hales Corners, WI
National Provider Identifier
1013594894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 5155 Brandons CT
Hales Corners, WI 53130 - Phone
- (414) 235-8310
- NPI assigned
- Mar 26, 2021
- 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 |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
5155 Brandons CT
Hales Corners, WI 53130
Mailing address
8843 Knoll CT
Franklin, WI 53132
Phone (262) 994-8310
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1013594894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8843 KNOLL CT",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "53132",
"telephone_number": "262-994-8310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5155 BRANDONS CT",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "53130",
"telephone_number": "414-235-8310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDA",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-26",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hales Corners, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.