Randall Potter, R.T(R)

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

RHF00104187 Issued in CA

Practice address

1385 Fernwood Dr # a
McKinleyville, CA 95519-6402

Phone

(805) 765-5347

NPI assigned

Jan 23, 2015

Last updated

Jan 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1518357987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 FERNWOOD DR # A",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955196402",
            "telephone_number": "805-765-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 FERNWOOD DR # A",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955196402",
            "telephone_number": "805-765-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "RANDALL",
        "credential": "R.T(R)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "RHF00104187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Pimentel III
• Vivianna Isabelle Plancarte
• Zoe Elizabeth Poer
• Rebecca Porteous, LCSW
• Eugene K Porterfield
• Maymi Preston-Donahue, LCSW
• Rad Connect Inc.
• Rad Connect L.L.C
• Caprice Ramsey, RN
• Ella Rawitch

• Radiologic Technologist in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.