Individual provider Active NPI

Jenci Randall, AU.D.

  • Audiologist
  • Ellensburg, WA
National Provider Identifier
1073917951
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD60518616 Issued in WA
Practice address
601 N Main St Ste 1
Ellensburg, WA 98926-6305
Phone
(509) 962-9575
NPI assigned
Oct 21, 2014
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X LD60518616 WA Primary

Addresses

Primary practice location

601 N Main St Ste 1
Ellensburg, WA 98926-6305

Mailing address

PO Box 880
Cle Elum, WA 98922-0880
Phone (419) 234-6629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231001888 WA Practitioner - Qualified Audiologist 9133442932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 N Main St
Suite 1
Ellensburg, WA 98926-6305
Phone (509) 962-9575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Cascade Audiology PLLC Audiologist CurrentSince Dec 31, 2019 Accepting new patients

Locations

110 S Oakes Ave
Ste 130
Cle Elum, WA 98922
Phone (509) 962-9575

601 N Main St
Ste 1
Ellensburg, WA 98926
Phone (509) 962-9575

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1073917951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "CLE ELUM",
            "state": "WA",
            "postal_code": "989220880",
            "telephone_number": "419-234-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N MAIN ST STE 1",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989266305",
            "telephone_number": "509-962-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JENCI",
        "name_prefix": "Ms.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60518616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.