Active NPI
Jamie Lee Randolph
- Clinical Social Worker
- New Britain, CT
National Provider Identifier
1124786231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13609
- Practice address
- 233 Main St
New Britain, CT 06051-4204 - Phone
- (860) 224-8192
- NPI assigned
- Dec 6, 2021
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13609 | CT | Primary |
Addresses
Primary practice location
233 Main St
New Britain, CT 06051-4204
Mailing address
233 Main St
New Britain, CT 06051-4204
Phone (860) 224-8192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1124786231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 MAIN ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060514204",
"telephone_number": "860-224-8192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 MAIN ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060514204",
"telephone_number": "860-224-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "JAMIE",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-06",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "13609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.