Randy L Andregg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP540 Issued in ID

Practice address

610 Americana Blvd
Boise, ID 83702-6731

Phone

(208) 344-2020

Fax

(208) 344-2371

NPI assigned

Sep 27, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Eagle Vision One PLLC

  dba Vision One Eagle

  • Optometrist
  • Eagle, ID
  • NPI 1699845503
  NPD (past)
• Vision One Inc

  dba Vision One

  • Optometrist
  • Boise, ID
  • NPI 1821168907
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1245321835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 AMERICANA BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026731",
            "telephone_number": "208-344-2020",
            "fax_number": "208-344-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 AMERICANA BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026731",
            "telephone_number": "208-344-2020",
            "fax_number": "208-344-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREGG",
        "first_name": "RANDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043245",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Steven Anderson, RN
• Skyler Anderson, PHARMD
• Stephanie Anderson, PHARMD
• Timothy Andreae, M.A., L.C.P.C.
• Aaron Lamar Andreasen, LPC
• Erin Andrew
• Nathan Andrew, MD
• Boyd J Andrews, DPM
• Haylee Andrews
• Janice Andrews, ACADC

• Optometrist in Boise, ID
• Providers in Boise, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.