Individual provider Active NPI

Rebecca Jean Randall, FNP-BC

  • Family Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1275903031
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2260990 Issued in MA
Practice address
819 Worcester St
Suite 3
Springfield, MA 01151-1045
Phone
(413) 543-6820
Fax
(413) 346-4060
NPI assigned
Oct 5, 2015
Last updated
Oct 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2260990 MA Primary

Addresses

Primary practice location

819 Worcester St
Suite 3
Springfield, MA 01151-1045

Mailing address

819 Worcester St
Suite 3
Springfield, MA 01151-1045
Phone (413) 543-6820

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2260990MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1275903031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511045",
            "telephone_number": "413-543-6820",
            "fax_number": "413-346-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511045",
            "telephone_number": "413-543-6820",
            "fax_number": "413-346-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2260990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.