Randall D Cobble, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10003668 Issued in WA

Practice address

550 Gage Blvd
Richland, WA 99352-9532

Phone

(509) 946-7646

Fax

(509) 946-7666

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Valley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1811946056
  NPD (past)
• Northwest Healthcare and Wellness Center, PLLC

  • Family Medicine Physician
  • Richland, WA
  • NPI 1194812305
  NPD (past)
• Washington Em-I Medical Services PC

  • Emergency Medicine Physician
  • Sunnyside, WA
  • NPI 1639128879
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1225074107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TORBETT ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542604",
            "telephone_number": "509-946-7646",
            "fax_number": "509-946-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-946-7646",
            "fax_number": "509-946-7666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Torbett St",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993542604",
            "country_code": "US",
            "telephone_number": "509-946-7646",
            "fax_number": "509-946-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBBLE",
        "first_name": "RANDALL",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005315",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Michelle Clements, MA, CCC-SLP
• Clinical Laboratories P S
• Crystal Clyde
• Joshua F Coates, PA C
• Therese Ann Cobb, MSW, BCETS, LSWAA
• Cody Crow (Crow Massage and Esthetics)
• Martin J Coker, M.D.
• Maisha Star Cole
• Minette Sharon Cole, PT, DPT, CF-L1
• Collette & Hamilton PLLC

• Medical Physician Assistant in Richland, WA
• Providers in Richland, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.