Randall M West, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5262 Issued in CA

Practice address

1731 Creekside Dr
100
Folsom, CA 95630-3457

Phone

(916) 984-4100

Fax

(916) 984-4154

NPI assigned

Oct 21, 2005

Last updated

Mar 9, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Creekside Osteopathic Family Practice Inc

  • Family Medicine Physician
  • Folsom, CA
  • NPI 1558395509
  NPD (past) Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1518957562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 CREEKSIDE DR",
            "address_2": "100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303457",
            "telephone_number": "916-984-4100",
            "fax_number": "916-984-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 CREEKSIDE DR",
            "address_2": "100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303457",
            "telephone_number": "916-984-4100",
            "fax_number": "916-984-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "RANDALL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A5262",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Werner
• Jennifer Jean West-Lackey, PHARMD
• Jordan West, LMFT
• Laura Ashbrook West, RN
• Mercedes West
• Westcoast Trauma and Testing Specialists, Inc. (Kap Wellness)
• Western Dental Services, Inc.
• Robyn E. Westlake, MD
• Ashley Weston, D.O.
• Stephanie Whatley

• Family Medicine Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.