Randall Lee Berry
Individual provider Active NPI Personal Care Attendant · Madison, WV
NPI 1265167282 · NPPES record last updated Jul 22, 2022
Key facts
- NPI
- 1265167282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 1 Avenue C Bulding
Madison, WV 25053 - Phone
- (304) 369-6400
- NPI assigned
- Jul 22, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
1 Avenue C Bulding
Madison, WV 25053
Mailing address
1 Avenue C Bulding
Madison, WV 25053
Phone (304) 369-6400
Other providers in Madison, WV
- Cassie Marie Bartley
- Jason Walter Bartley
- Sandra Kay Bartley
- Cassandra Basiden
- Katie Berry
- Alashae Bias
- Joseph Bias
- Tammy Bias
- Kristin Billups
- Shyla Blackburn
All providers in Madison, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.