Annette Randlemon, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R25038 Issued in NM

Practice address

2300 E 30TH St
BLDG B, Suite 102
Farmington, NM 87401-8990

Phone

(505) 324-1000

Fax

(505) 324-1199

NPI assigned

Jul 14, 2006

Sex

Female

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 8

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13887/brand/1/csg/1/fhir/r4

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.

• Pinon Family Practice PC

  • Family Medicine Physician
  • Farmington, NM
  • NPI 1598879652
  Medicare reassignment NPD
• Pelle Laser Spa

  • Women's Health Nurse Practitioner
  • Farmington, NM
  • NPI 1326885039
  NPD Authorized official
• Southwest Spine & Orthopedic Clinic PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Farmington, NM
  • NPI 1922057892
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1366468159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 SIERRA AVE",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101540",
            "telephone_number": "505-334-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST",
            "address_2": "BLDG B, SUITE 102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018990",
            "telephone_number": "505-324-1000",
            "fax_number": "505-324-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLEMON",
        "first_name": "ANNETTE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R25038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "850462631",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "850462631",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE SALUD",
            "identifier": "10002777",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "201016092",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "32D0943693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S3309",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMC",
            "identifier": "400521029",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NM006F13",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Ellen Rago, PA-C
• Krista Leigh Rainwater, LPC
• Alice A Rakestraw, LMHC
• Thomas John Ramage IV, DPT
• Darren Rasheed Ramoutar, D.O.
• Erin Randolph, PTA
• R Stephen Rankin, MD
• Derek Raring
• Aaron D Rasmussen, DDS
• Erin Raykiewicz

• Family Nurse Practitioner in Farmington, NM
• Providers in Farmington, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.