Individual provider Active NPI

Randall Walter Nameth, DDS

  • Dentist
  • Worthington, OH
National Provider Identifier
1073530663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.017679 Issued in OH
Practice address
716 Worthington Woods Blvd
Worthington, OH 43085-5713
Phone
(614) 846-2222
Fax
(614) 846-3020
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.017679 OH Primary

Addresses

Primary practice location

716 Worthington Woods Blvd
Worthington, OH 43085-5713

Mailing address

716 Worthington Woods Blvd
Worthington, OH 43085-5713
Phone (614) 846-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170526001893 OH Order and Referring Only - DentistPractitioner - Dentist 8224349535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073530663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 WORTHINGTON WOODS BLVD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430855713",
            "telephone_number": "614-846-2222",
            "fax_number": "614-846-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 WORTHINGTON WOODS BLVD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430855713",
            "telephone_number": "614-846-2222",
            "fax_number": "614-846-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMETH",
        "first_name": "RANDALL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.017679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.