Active NPI
Madison Rose Randak
- Student in an Organized Health Care Education/Training Program
- Monroe, LA
National Provider Identifier
1417832254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- BP10099245
- Practice address
- 4408 Bon Aire Dr
Monroe, LA 71203-3111 - Phone
- (318) 342-7100
- NPI assigned
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10099245 | TX | Primary |
Addresses
Primary practice location
4408 Bon Aire Dr
Monroe, LA 71203-3111
Mailing address
4408 Bon Aire Dr
Monroe, LA 71203-3111
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 |
|---|---|---|---|
| BP10099245 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1417832254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4408 BON AIRE DR",
"city": "MONROE",
"state": "LA",
"postal_code": "712033111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4408 BON AIRE DR",
"city": "MONROE",
"state": "LA",
"postal_code": "712033111",
"telephone_number": "318-342-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDAK",
"first_name": "MADISON",
"middle_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-11",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "BP10099245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.