Active NPI
Roberta Randall, LD
- Registered Dietitian
- Orrville, OH
National Provider Identifier
1093146201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 496403
- Practice address
- 365 S Crown Hill Rd
Orrville, OH 44667-9527 - Phone
- (330) 452-9911
- NPI assigned
- Dec 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 496403 | OH | Primary |
Addresses
Primary practice location
365 S Crown Hill Rd
Orrville, OH 44667-9527
Mailing address
2600 Sixth St SW
Canton, OH 44710-1702
Phone (330) 452-9911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 496403 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1093146201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 SIXTH ST SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447101702",
"telephone_number": "330-452-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 S CROWN HILL RD",
"city": "ORRVILLE",
"state": "OH",
"postal_code": "446679527",
"telephone_number": "330-452-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "ROBERTA",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-13",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "496403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orrville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.