Active NPI
Zachery Michael Randall
- Adult Companion
- Wayne, NE
National Provider Identifier
1245106129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 611 Valley Dr Ste a
Wayne, NE 68787-2277 - Phone
- (402) 833-1080
- NPI assigned
- Oct 16, 2025
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | NE | Primary |
Addresses
Primary practice location
611 Valley Dr Ste a
Wayne, NE 68787-2277
Mailing address
107 N 5TH St
Pender, NE 68047-4143
Phone (402) 742-0311
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760572800000",
"number": "1245106129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 N 5TH ST",
"city": "PENDER",
"state": "NE",
"postal_code": "680474143",
"telephone_number": "402-742-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 VALLEY DR STE A",
"city": "WAYNE",
"state": "NE",
"postal_code": "687872277",
"telephone_number": "402-833-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "ZACHERY",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-16",
"last_updated": "2025-10-16",
"certification_date": "2025-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "NE",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.