Randall Habecker Wiest, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AA 1925 Issued in AK

Practice address

4136 Bartlett St
Homer Medical Clinic
Homer, AK 99603-7001

Phone

(907) 235-8586

Fax

(907) 235-6639

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Homer Medical Clinic, a Professional Corp

  • Family Medicine Physician
  • Homer, AK
  • NPI 1134277312
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235264409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1489",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996031489",
            "telephone_number": "907-235-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 BARTLETT ST",
            "address_2": "HOMER MEDICAL CLINIC",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037001",
            "telephone_number": "907-235-8586",
            "fax_number": "907-235-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "RANDALL",
        "middle_name": "HABECKER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "AA 1925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080153698",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD19252",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sava White
• Nicholas Whiting
• Dana Whittaker, CNM
• Whole Mind, LLC
• Cody Wicken
• Anna Jeanne Williams, ANP, NP-C
• Darren Daniel Williams
• Jak Wilmot
• Marin Wilson
• Susanne Ratcliffe Wilson, MFT

• Family Medicine Physician in Homer, AK
• Providers in Homer, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.