Individual provider Active NPI

Brittany Joyce Randall, OTD, OTR/L

  • Occupational Therapist
  • Charleston, SC
National Provider Identifier
1336823046
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6852 Issued in SC
Practice address
1744 Sam Rittenberg Blvd
Charleston, SC 29407-4935
Phone
(843) 474-2240
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6852 SC Primary

Addresses

Primary practice location

1744 Sam Rittenberg Blvd
Charleston, SC 29407-4935

Mailing address

1744 Sam Rittenberg Blvd
Charleston, SC 29407-4935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628002825 SC Practitioner - Occupational Therapist in Private Practice 7911366604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6852SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Tides Speech and Language L.L.C. Occupational Therapist CurrentSince Jun 13, 2023 Accepting new patients

Locations

1744 Sam Rittenberg Blvd
Charleston, SC 29407
Phone (843) 270-3412

1744 Sam Rittenberg Blvd
Ste E
Charleston, SC 29407
Phone (607) 423-6613

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1336823046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074935",
            "telephone_number": "843-474-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "BRITTANY",
        "middle_name": "JOYCE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.