Active NPI
Randy Duane Jayne, R.PH.
- Pharmacist
- Banning, CA
National Provider Identifier
1013936350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH38586
- Practice address
- 1035 W Ramsey St Ste B3
Banning, CA 92220-4400 - Phone
- (951) 849-4920
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- 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 | RPH38586 | CA | Primary |
Addresses
Primary practice location
1035 W Ramsey St Ste B3
Banning, CA 92220-4400
Mailing address
22124 Drover Way
Canyon Lake, CA 92587-7608
Phone (951) 244-6886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA438830 | Medicaid | CA |
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 |
|---|---|---|---|
| RPH38586 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas L Pierick | Past | Accepting new patients |
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": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013936350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22124 DROVER WAY",
"city": "CANYON LAKE",
"state": "CA",
"postal_code": "925877608",
"telephone_number": "951-244-6886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 W RAMSEY ST STE B3",
"city": "BANNING",
"state": "CA",
"postal_code": "922204400",
"telephone_number": "951-849-4920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYNE",
"first_name": "RANDY",
"middle_name": "DUANE",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH38586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHA438830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.