Individual provider Active NPI

Nancy Tidwell Randall

  • Pharmacist
  • Lexington, KY
National Provider Identifier
1295081032
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
008929 Issued in KY
Practice address
1600 Leestown Rd
Lexington, KY 40511-2136
Phone
(859) 259-0965
Fax
(859) 259-0971
NPI assigned
Jul 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 008929 KY Primary

Addresses

Primary practice location

1600 Leestown Rd
Lexington, KY 40511-2136

Mailing address

1600 Leestown Rd
Lexington, KY 40511-2136
Phone (859) 259-0965

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

State licenses

LicenseStateTypeSpecialty
008929KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1295081032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112136",
            "telephone_number": "859-259-0965",
            "fax_number": "859-259-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112136",
            "telephone_number": "859-259-0965",
            "fax_number": "859-259-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "NANCY",
        "middle_name": "TIDWELL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "008929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.