Randy Roy Lundell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5807043-1204 Issued in UT

Practice address

954 N 200 E Ste 954
Spanish Fork, UT 84660-1247

Phone

(801) 504-6117

Fax

(801) 504-6328

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rejuvaroom LLC

  • Family Medicine Physician
  • Spanish Fork, UT
  • NPI 1528665411
  NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1336239888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 S MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602410",
            "telephone_number": "801-504-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 N 200 E STE 954",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601247",
            "telephone_number": "801-504-6117",
            "fax_number": "801-504-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "RANDY",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5807043-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LISC. #",
            "identifier": "5807043-1204",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "randy.lundell@direct.imail.org",
            "affiliation": "N",
            "address_1": "954 N 200 E Ste 954",
            "city": "Spanish Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846601247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Breeana Loveland
• Isabell Lucero
• Nissa Breann Lucero, NP-C
• Serenity Dawn Lucio, TRT
• David E Ludlow, M.D.
• Scott Duane Lynde
• Carter S Lytle, M.D.
• Maceys Inc
• Luis Fernando Macias, LMT
• Diane Grow Maciel, LCSW

• Family Medicine Physician in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.