Active NPI
Randall Flynt, MDIV
- Pastoral Counselor
- Pueblo, CO
National Provider Identifier
1255722989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 805 Eagleridge Blvd
Pueblo, CO 81008-2193 - Phone
- (719) 287-6282
- NPI assigned
- Feb 17, 2015
- Last updated
- Feb 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | CO | Primary |
Addresses
Primary practice location
805 Eagleridge Blvd
Pueblo, CO 81008-2193
Mailing address
805 Eagleridge Blvd
Pueblo, CO 81008-2193
Phone (719) 287-6282
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": "1424131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1255722989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 EAGLERIDGE BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082193",
"telephone_number": "719-287-6282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 EAGLERIDGE BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082193",
"telephone_number": "719-287-6282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNT",
"first_name": "RANDALL",
"credential": "MDIV",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-17",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "CO",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.