Dorrie Randall

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002068137 Issued in VA

Practice address

2002 Plainview Lane
Shacklefords, VA 23156

Phone

(804) 832-7885

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dorrie G Randall Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1144780792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 PLAINVIEW LANE",
            "city": "SHACKLEFORDS",
            "state": "VA",
            "postal_code": "23156",
            "telephone_number": "804-832-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 PLAINVIEW LANE",
            "city": "SHACKLEFORDS",
            "state": "VA",
            "postal_code": "23156",
            "telephone_number": "804-832-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "DORRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002068137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Shacklefords",
            "affiliation": "N",
            "endpointDescription": "home base",
            "address_1": "2002 Plainview lane",
            "city": "Shacklefords",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DORRIE",
            "last_name": "RANDALL",
            "middle_name": "G",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Samantha Jaelene Fary, PHARMD
• Valarie Denise Kelly, RN
• Lower King and Queen County Volunteer Fire Department Inc

• All providers in Shacklefords, VA
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.