Individual provider Active NPI

Randy J. Fearing, D.C.

  • Chiropractor
  • Gainesville, FL
National Provider Identifier
1104806579
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2440 Issued in FL
Practice address
4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570
Phone
(352) 377-5158
Fax
(352) 377-4303
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2440 FL Primary
Neurology Chiropractor 111NN0400X CH2440 FL

Addresses

Primary practice location

4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570

Mailing address

4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570
Phone (352) 377-5158

Other identifiers 2

IdentifierTypeStateIssuer
050318500MedicaidFL
89904OtherFLBLUE CROSS BLUE SHIELD FL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000426 FL Practitioner - Chiropractic 0648463455 Reassigns benefits to 1 organization
Practice locations: Gainesville, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570
Phone (352) 377-5158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH2440FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Back and Neck Pain Relief Chiropractic,LLC Chiropractor CurrentSince Mar 7, 2022 Accepting new patients
Randy J. Fearing, DC Chiropractor PastSince Jul 1, 1976 Accepting new patients
Randy J. Fearing, DC Neurology PastSince Jul 1, 1976 Accepting new patients

Locations

4509 NW 23rd Ave
Ste 6
Gainesville, FL 32606
Phone (352) 377-5158

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1104806579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 NW 23RD AVE",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066570",
            "telephone_number": "352-377-5158",
            "fax_number": "352-377-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 NW 23RD AVE",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066570",
            "telephone_number": "352-377-5158",
            "fax_number": "352-377-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARING",
        "first_name": "RANDY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2440",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH2440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050318500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "89904",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.