Individual provider Active NPI

Paige Williams Randall, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Boone, NC
National Provider Identifier
1447642467
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1506028 Issued in NC
Practice address
1179 State Farm Rd
Boone, NC 28607-4943
Phone
(828) 262-7677
NPI assigned
Feb 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1506028 NC Primary

Addresses

Primary practice location

1179 State Farm Rd
Boone, NC 28607-4943

Mailing address

1179 State Farm Rd
Boone, NC 28607-4943
Phone (828) 262-7677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903001946 NC Practitioner - Qualified Speech Language Pathologist 4880133909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 University Hall Dr
Boone, NC 28807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1506028NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian State University Speech-Language Pathologist CurrentSince Jul 25, 2024 Accepting new patients
Appalachian State University CurrentSince Jul 25, 2024 Accepting new patients
Appalachian State University CurrentSince Jul 25, 2024 Accepting new patients
Watauga Medical Center, Inc. Past Accepting new patients

Locations

1179 State Farm Rd
Boone, NC 28607
Phone (828) 262-7677

1179 State Farm Rd
Ste 132
Boone, NC 28607
Phone (828) 262-8658

Organizations & group practices 4

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": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1447642467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 STATE FARM RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074943",
            "telephone_number": "828-262-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 STATE FARM RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074943",
            "telephone_number": "828-262-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "PAIGE",
        "middle_name": "WILLIAMS",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "1506028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.