NPIMap

Organization Active NPI

Randy E Waddell

  • Optometrist
  • Greybull, WY
National Provider Identifier
1093983025
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
133T Issued in WY
Legal business name
RANDY E WADDELL
Practice address
426 Greybull Ave
Greybull, WY 82426-2037
Phone
(307) 765-2998
Fax
(307) 765-2614
NPI assigned
Feb 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Randy E WaddellNPI 1679573380
Title
Owner
Phone
(307) 765-2998

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 133T WY Primary

Addresses

Primary practice location

426 Greybull Ave
Greybull, WY 82426-2037

Mailing address

426 Greybull Ave
Greybull, WY 82426-2037
Phone (307) 765-2998

National Provider Directory

National Provider Directory

Locations

426 Greybull Ave
Greybull, WY 82426
Phone (307) 765-2998

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1093983025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262037",
            "telephone_number": "307-765-2998",
            "fax_number": "307-765-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262037",
            "telephone_number": "307-765-2998",
            "fax_number": "307-765-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY E WADDELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-765-2998"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WY",
            "license": "133T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greybull, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.