Individual provider Active NPI

Ineta Moore Randle

  • Non-emergency Medical Transport (VAN)
  • West Point, MS
National Provider Identifier
1407322159
Registry record updated Oct 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
124 Crowell St
West Point, MS 39773-7568
Phone
(662) 295-1299
Fax
(662) 492-1961
NPI assigned
Oct 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary
DriverGroup: 193400000X SINGLE SPECIALTY GROUP 172A00000X

Addresses

Primary practice location

124 Crowell St
West Point, MS 39773-7568

Mailing address

124 Crowell St
West Point, MS 39773-7568
Phone (662) 295-1299

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

NPI Registry JSON

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

{
    "created_epoch": "1540080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540080000000",
    "number": "1407322159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 CROWELL ST",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397737568",
            "telephone_number": "662-295-1299",
            "fax_number": "662-492-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 CROWELL ST",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397737568",
            "telephone_number": "662-295-1299",
            "fax_number": "662-492-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "INETA",
        "middle_name": "MOORE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-21",
        "last_updated": "2018-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Point, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2018; 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.