Kelli Randell, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01071612A Issued in IN

Practice address

3475 N Saratoga St
Oak Harbor, WA 98278

Phone

(360) 257-9561

NPI assigned

Jun 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1063707198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 N SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982784927",
            "telephone_number": "360-257-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 N SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "98278",
            "telephone_number": "360-257-9561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-8225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDELL",
        "first_name": "KELLI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01071612A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Elmer Ralston, M.D.
• Christopher G Ramos, M.D.
• Shawnacy Lynn Ramos
• Mary Lindsay Ramsey
• Eana Randall
• Elizabeth Reardon
• Marguerite O Redmond, LMP
• Janette Marie Reeves, D.O.
• Cindy Renee Rehberg, LMP
• Lynda Reidling, NURSE PRACTITIONER

• Internal Medicine Physician in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.