Individual provider Active NPI

Randall Allan Pierce, MD

  • Diagnostic Radiology Physician
  • Sparks, NV
National Provider Identifier
1174511067
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9213 Issued in NV
Practice address
2375 E. Prater Way
Sparks Radiology
Sparks, NV 89434
Phone
(775) 331-7000
Fax
(775) 825-6090
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9213 NV Primary

Addresses

Primary practice location

2375 E. Prater Way
Sparks Radiology
Sparks, NV 89434

Mailing address

4877 Ramcreek TRL
Reno, NV 89519-8028
Phone (775) 224-5880

Other identifiers 1

IdentifierTypeStateIssuer
100500052MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103000400 NV Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3971576182 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
University of California, San Francisco School of Medicine, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2031 32ND St S
Suite 100
La Crosse, WI 54601-7099

4877 Ramcreek TRL
Reno, NV 89519-8028

525 W Brown Rd
FL 9
Mesa, AZ 85201-3202

Hospital & facility affiliations

  • Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59581CAMDGeneral Practice Dentistry
9213NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sparks Radiology Group LTD. Diagnostic Radiology CurrentSince Jun 1, 2003 Accepting new patients
Banner Health CurrentSince Aug 12, 2023 Accepting new patients
Northstar Radiology Diagnostic Radiology CurrentSince Oct 1, 2015 Accepting new patients

Locations

500 1st Ave
Portola, CA 96122
Phone (530) 832-4277

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

1500 Avenue H
Ely, NV 89301
Phone (775) 289-3001

801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

1235 Menomonie St
Ste B
Eau Claire, WI 54703

2031 32nd St S
La Crosse, WI 54601
Phone (608) 788-8100

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1174511067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4877 RAMCREEK TRL",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895198028",
            "telephone_number": "775-224-5880",
            "fax_number": "775-825-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E. PRATER WAY",
            "address_2": "SPARKS RADIOLOGY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "89434",
            "telephone_number": "775-331-7000",
            "fax_number": "775-825-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "RANDALL",
        "middle_name": "ALLAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "9213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500052",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.