Individual provider Active NPI

Randall Lee Mullins

  • Case Manager/Care Coordinator
  • Los Angeles, CA
National Provider Identifier
1477740140
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
695 S Vermont Ave
8TH Floor
Los Angeles, CA 90005-1349
Phone
(213) 480-3460
Fax
(213) 252-8878
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

695 S Vermont Ave
8TH Floor
Los Angeles, CA 90005-1349

Mailing address

695 S Vermont Ave
9TH Floor
Los Angeles, CA 90005-1349
Phone (213) 480-3460

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Past Accepting new patients

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1477740140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 S VERMONT AVE",
            "address_2": "9TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051349",
            "telephone_number": "213-480-3460",
            "fax_number": "213-252-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 S VERMONT AVE",
            "address_2": "8TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051349",
            "telephone_number": "213-480-3460",
            "fax_number": "213-252-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.