Active NPI
Ada Pauline Randall
- Licensed Vocational Nurse
- Anchorage, AK
National Provider Identifier
1306131446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 142293
- Practice address
- 670 W Fireweed LN Ste 160
Anchorage, AK 99503-2561 - Phone
- (907) 770-0862
- NPI assigned
- Jun 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 253763 | CA | |
| Licensed Vocational Nurse | 164X00000X | 142293 | AK | Primary |
Addresses
Primary practice location
670 W Fireweed LN Ste 160
Anchorage, AK 99503-2561
Mailing address
648 Whitetail Dr
Fleetwood, NC 28626-9280
Phone (706) 331-3508
Other practice location 1
427 C St
Suite 212
San Diego, CA 92101-5100
Phone (619) 238-4180
Other practice location 2
648 Whitetail Dr
Fleetwood, NC 28626-9280
Phone (706) 331-3508
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
| License | State | Type | Specialty |
|---|---|---|---|
| 142293 | AK | MD | Licensed Vocational Nurse |
| 253763 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550707200000",
"number": "1306131446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 WHITETAIL DR",
"city": "FLEETWOOD",
"state": "NC",
"postal_code": "286269280",
"telephone_number": "706-331-3508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 W FIREWEED LN STE 160",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995032561",
"telephone_number": "907-770-0862"
}
],
"practiceLocations": [
{
"address_1": "427 C St",
"address_2": "Suite 212",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921015100",
"country_code": "US",
"telephone_number": "619-238-4180",
"fax_number": "618-238-4245",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "648 Whitetail Dr",
"address_purpose": "LOCATION",
"city": "Fleetwood",
"state": "NC",
"postal_code": "286269280",
"country_code": "US",
"telephone_number": "706-331-3508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANDALL",
"first_name": "ADA",
"middle_name": "PAULINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-16",
"last_updated": "2019-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "253763",
"primary": false
},
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "AK",
"license": "142293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.