Active NPI
Randal Isaac Queen, ED.S.
- School Psychologist
- Roanoke, VA
National Provider Identifier
1215448188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 0813000201
- Practice address
- 5901 Cove Rd
Roanoke, VA 24019-2403 - Phone
- (540) 562-3900
- NPI assigned
- Oct 19, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 0813000201 | VA | Primary |
Addresses
Primary practice location
5901 Cove Rd
Roanoke, VA 24019-2403
Mailing address
5901 Cove Rd
Roanoke, VA 24019-2403
Phone (540) 562-3900
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0813000201 | VA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1215448188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 COVE RD",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240192403",
"telephone_number": "540-562-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 COVE RD",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240192403",
"telephone_number": "540-562-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "RANDAL",
"middle_name": "ISAAC",
"name_prefix": "Mr.",
"credential": "ED.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-19",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0813000201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
- Quality of Life Medical Specialties, PLLC
- Eugenie Yu Quan, MD
- Abigail Elizabeth Quantock, FNP
- Calandra Quarles
- Glenn Richard Quarles Jr., D.O.
- Queenpin Family Wellness, LLC
- Lesley Arthur Quesenberry, PA-C
- Quest Diagnostics Clinical Laboratories Inc
- Quest Diagnostics Clinical Laboratories Inc
- Quest Diagnostics Clinical Laboratories Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.