NPIMap

Individual provider Active NPI

Randle S Miskelly, APN

  • Family Nurse Practitioner
  • Henderson, TN
National Provider Identifier
1013948066
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11859 Issued in TN
Practice address
1306 US Highway 45 N
Henderson, TN 38340-4003
Phone
(731) 989-9899
Fax
(731) 989-3495
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11859 TN Primary

Addresses

Primary practice location

1306 US Highway 45 N
Henderson, TN 38340-4003

Mailing address

1306 US Highway 45 N
Henderson, TN 38340-4003
Phone (731) 989-9899

Other identifiers 1

IdentifierTypeStateIssuer
3643080MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000692 TN Practitioner - Nurse Practitioner 2365452851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Family Medicine IncGroup PAC ID 8022039718, 7 clinicians

Practice addresses (Care Compare)

1306 US Hwy 45 N
Henderson, TN 38340-4003
Phone (731) 989-9899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.87 of 100Reported as group
Quality
100
Improvement activities
40
Cost
82.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11859TNMDNeurology Physical Therapist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHIJBD/Endpoint/HHIJBD

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1013948066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 US HIGHWAY 45 N",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383404003",
            "telephone_number": "731-989-9899",
            "fax_number": "731-989-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 US HIGHWAY 45 N",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383404003",
            "telephone_number": "731-989-9899",
            "fax_number": "731-989-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISKELLY",
        "first_name": "RANDLE",
        "middle_name": "S",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "11859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3643080",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.