Jeffrey G Randle, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2944031205 Issued in UT

Practice address

1160 E 3900 S
#5000
Salt Lake City, UT 84124-1275

Phone

(801) 262-8486

Fax

(801) 284-8699

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physical Medicine and Rehabilitation

Education

University of Utah School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salt Lake Orthopaedic Specialist LLCGroup PAC ID 3173422730, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alexanders Fitness Company LLC

  dba ALX Family Health

  • Physical Medicine & Rehabilitation Physician
  • Lindon, UT
  • NPI 1518583566
  Medicare reassignment NPD Authorized official
• Salt Lake Orthopaedic Specialist, LLC

  dba Salt Lake Orthopaedic Clinic

  • Specialist
  • Salt Lake City, UT
  • NPI 1811913429
  Medicare reassignment Care Compare group NPD
• Salt Lake Orthopaedic Specialist, LLC

  dba Stanely J. Phillips DPM

  • Foot & Ankle Surgery Podiatrist
  • American Fork, UT
  • NPI 1417833419
  NPD
• Salt Lake Orthopaedic Specialist, LLC

  dba Scott Romney McKell DPM

  • Foot & Ankle Surgery Podiatrist
  • Orem, UT
  • NPI 1295611291
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1063404424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106236",
            "telephone_number": "801-505-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S",
            "address_2": "#5000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241275",
            "telephone_number": "801-262-8486",
            "fax_number": "801-284-8699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2326 N 400 E Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840743460",
            "country_code": "US",
            "telephone_number": "435-241-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "2944031205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1019",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• L Harper Randall, MD
• Michelle Sabrina Randall, APC
• Zane Randell
• Brian Randle, DMD
• Emily A Randle
• Kimberly Randolph
• Loren J Randolph, MS
• Aileen Rands, PHD
• Jackson Rands
• Randy N Downing DDS PC

• Physical Medicine & Rehabilitation Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Medicine & Rehabilitation Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.