Individual provider Active NPI

Joseph Randall

  • Clinical Social Worker
  • Martinsburg, WV
National Provider Identifier
1447845870
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BP00945874 Issued in WV
Practice address
312 W King St
Martinsburg, WV 25401-3202
Phone
(304) 261-8456
Fax
(877) 917-9562
NPI assigned
Mar 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X BP00945874 WV Primary

Addresses

Primary practice location

312 W King St
Martinsburg, WV 25401-3202

Mailing address

312 W King St
Martinsburg, WV 25401-3202
Phone (304) 261-8456

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

LicenseStateTypeSpecialty
BP00945874WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Simms Integrative Health Services Inc Clinical CurrentSince Mar 16, 2021 Accepting new patients

Locations

312 W King St
Martinsburg, WV 25401
Phone (304) 261-8456

Organizations & group practices 1

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1447845870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W KING ST",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254013202",
            "telephone_number": "304-261-8456",
            "fax_number": "877-917-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W KING ST",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254013202",
            "telephone_number": "304-261-8456",
            "fax_number": "877-917-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "BP00945874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.