Active NPI
Suzanne Marie Randall, LMT
- Prevention Professional
- Dunmore, PA
National Provider Identifier
1093249187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- MSG010857
- Practice address
- 439 E Drinker St
Dunmore, PA 18512-2483 - Phone
- (570) 955-5435
- NPI assigned
- Apr 14, 2017
- Last updated
- Apr 14, 2017
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | MSG010857 | PA | Primary |
Addresses
Primary practice location
439 E Drinker St
Dunmore, PA 18512-2483
Mailing address
439 E Drinker St
Dunmore, PA 18512-2483
Phone (570) 955-5435
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 |
|---|---|---|---|
| MSG010857 | PA | MD | Prevention Professional |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JT Wellness | Past | Accepting new patients |
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": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1093249187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 E DRINKER ST",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185122483",
"telephone_number": "570-955-5435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 E DRINKER ST",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185122483",
"telephone_number": "570-955-5435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "SUZANNE",
"middle_name": "MARIE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "PA",
"license": "MSG010857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunmore, PA
- Vincent Pollino, MD
- Kellen NA Povanda I, LPN
- Price Chopper Operating Co of PA Inc (Price Chopper Pharmacy)
- Primary Care Medical Associates, P.C.
- Professional Neurological Associates PC
- Regional Foot & Ankle Center PC
- Renal Life Link Inc (Dunmore Dialysis)
- Ronald Ricci III, LPN
- Kristen Anne Ricciardi, CRNP
- Candace Lynne Riedel, AS, BA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.