Individual provider Active NPI

Randi Alyssa Lee, D.C.

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1255572848
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11045 Issued in TX
Practice address
16990 Dallas Pkwy
Suite #106
Dallas, TX 75248-1926
Phone
(972) 733-4422
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11045 TX Primary

Addresses

Primary practice location

16990 Dallas Pkwy
Suite #106
Dallas, TX 75248-1926

Mailing address

4909 Golden Triangle Blvd Ste 221
Fort Worth, TX 76244-4669
Phone (817) 741-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190503000952 TX Practitioner - Chiropractic 2264774694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4909 Golden Triangle Blvd
Suite 221
Fort Worth, TX 76244-4669
Phone (817) 741-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Family Chiropractic PLLC Chiropractor CurrentSince Jun 15, 2023 Accepting new patients

Locations

4909 Golden Triangle Blvd
Ste 221
Fort Worth, TX 76244
Phone (817) 741-8040

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1255572848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 GOLDEN TRIANGLE BLVD STE 221",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444669",
            "telephone_number": "817-741-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16990 DALLAS PKWY",
            "address_2": "SUITE #106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481926",
            "telephone_number": "972-733-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RANDI",
        "middle_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.