Active NPI
Randall Beaubouef, MSW
- Clinical Social Worker
- Cheyenne, WY
National Provider Identifier
1356647291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 451
- Practice address
- 2909 Bent Ave
Cheyenne, WY 82001-2742 - Phone
- (307) 742-6222
- Fax
- (307) 742-9905
- NPI assigned
- Feb 9, 2011
- Last updated
- Feb 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 451 | WY | Primary |
Addresses
Primary practice location
2909 Bent Ave
Cheyenne, WY 82001-2742
Mailing address
PO Box 1304
Laramie, WY 82073-1304
Phone (307) 742-6222
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 |
|---|---|---|---|
| 451 | WY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pendley and Associates, Inc | Past | Accepting new patients | |
| Pendley & Associates Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1356647291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1304",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820731304",
"telephone_number": "307-742-6222",
"fax_number": "307-742-9905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2909 BENT AVE",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820012742",
"telephone_number": "307-742-6222",
"fax_number": "307-742-9905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUBOUEF",
"first_name": "RANDALL",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.