Individual provider Active NPI

Randi Pickett, D.C

  • Chiropractor
  • Mukilteo, WA
National Provider Identifier
1154869113
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60691551 Issued in WA
Practice address
11811 Mukilteo Speedway Ste 105
Mukilteo, WA 98275-5442
Phone
(901) 326-8813
NPI assigned
Feb 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60691551 WA Primary

Addresses

Primary practice location

11811 Mukilteo Speedway Ste 105
Mukilteo, WA 98275-5442

Mailing address

11811 Mukilteo Speedway
Unit 105
Everett, WA 98275
Phone (901) 326-8813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170717000615 WA Practitioner - Chiropractic 2860761467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11811 Mukilteo Speedway
Suite 105
Mukilteo, WA 98275-5442
Phone (425) 348-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMR Chiropractic, PLLC Chiropractor CurrentSince May 3, 2017 Accepting new patients

Locations

11811 Mukilteo Speedway
Ste 105
Mukilteo, WA 98275
Phone (425) 348-3400

Organizations & group practices 1

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": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1154869113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 MUKILTEO SPEEDWAY",
            "address_2": "UNIT 105",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98275",
            "telephone_number": "901-326-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 MUKILTEO SPEEDWAY STE 105",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755442",
            "telephone_number": "901-326-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "RANDI",
        "name_prefix": "Mrs.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60691551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.