Randall H Beckett, DNP, DC, APRN, NP-C
Individual provider Active NPI Family Nurse Practitioner · Mt Pleasant, SC
NPI 1497705396 · NPPES record last updated Jan 10, 2015
Key facts
- NPI
- 1497705396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F2945 (SC)
- Practice address
- 1433 Wellesley Cir
Mt Pleasant, SC 29466-9047 - Phone
- (843) 412-3042
- Fax
- (803) 335-5151
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Encounter Telehealth Inc
Practice addresses (Care Compare)
1035 Division St
Green Bay, WI 54303-2903
Phone (844) 485-3041
1433 Wellesley Cir
Mount Pleasant, SC 29466-9047
Phone (844) 485-3041
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110829000005 | SC | Practitioner - Nurse Practitioner | 8921278003 | Reassigns benefits to 2 organizations |
| I20230519000497 | WI | Practitioner - Nurse Practitioner | 8921278003 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0905 | SC | MD | Chiropractor |
| 2945 | SC | MD | Occupational Therapy Assistant |
| F2945 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Current |
Accepting new patients | |
| South Carolina Department of Mental Health Accounting Office | Current |
Accepting new patients | |
| Carter'S Counseling Services, PLC | Past |
Accepting new patients |
Locations
2715 Colonial Dr
Columbia, SC 29203
Phone (803) 898-4777
1800 Colonial Dr
Columbia, SC 29203
Phone (803) 898-0123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0905 | SC | |
| Family Nurse Practitioner | 363LF0000X | F2945 | SC | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F2945 | SC |
Addresses
Primary practice location
1433 Wellesley Cir
Mt Pleasant, SC 29466-9047
Mailing address
1433 Wellesley Cir
Mt Pleasant, SC 29466-9047
Phone (843) 412-3042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A136003 | Other | IA | STATE LICENSE APRN FAMILY NURSE PRACTITIONER |
| NA2327003 | Other | NE | MEDICARE PTAN |
| 2945 | Other | SC | SOUTH BOARD OF NURSING LICENSE |
| IB3119001 | Other | IA | MEDICARE PTAN |
| AA72480281 | Other | SC | MEDICARE PTAN |
| 111635 | Other | NE | STATE LICENSE APRN |
| G136033 | Other | IA | STATE LICENSE APRN PSYCH/MENTAL HEALTH |
Other providers in Mt Pleasant, SC
- Mary P Bebensee
- Alice M Beck
- Michael Becker
- Scott Becker
- Sharon Jane Becker
- Glen Eric Beckner
- David Behrens
- William Behrens
- Being in Motion, LLC
- Amy Beitel
All providers in Mt Pleasant, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.