Individual provider Active NPI

Randall Mayo, RN

  • Registered Nurse
  • Birmingham, AL
National Provider Identifier
1114405545
Registry record updated Jul 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-117452 Issued in AL
Practice address
2009 Kirkman Dr
Birmingham, AL 35242-4639
Phone
(205) 807-2510
NPI assigned
Jul 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-117452 AL Primary

Addresses

Primary practice location

2009 Kirkman Dr
Birmingham, AL 35242-4639

Mailing address

2009 Kirkman Dr
Birmingham, AL 35242-4639
Phone (205) 807-2510

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-117452ALMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1532736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532736000000",
    "number": "1114405545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 KIRKMAN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424639",
            "telephone_number": "205-807-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 KIRKMAN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424639",
            "telephone_number": "205-807-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "RANDALL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-28",
        "last_updated": "2018-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-117452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2018; 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.