Individual provider Active NPI

Randi Blackmon Likely, DC

  • Chiropractor
  • Houston, TX
National Provider Identifier
1528701166
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15153 Issued in TX
Practice address
17047 El Camino Real Ste 140
Houston, TX 77058-2615
Phone
(713) 321-0506
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15153 TX Primary

Addresses

Primary practice location

17047 El Camino Real Ste 140
Houston, TX 77058-2615

Mailing address

2578 Madison Ave
League City, TX 77573-4566

Other names 1

  • Randi B. Likely Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@backedbyblackmon.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026001538 TX Practitioner - Chiropractic 7315313756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17047 El Camino Real
Suite 140
Houston, TX 77058-2615
Phone (713) 321-0506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15153TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Backed by Blackmon CurrentSince Jul 7, 2022 Accepting new patients

Locations

17047 El Camino Real
Ste 140
Houston, TX 77058
Phone (713) 321-0506

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": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1528701166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2578 MADISON AVE",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17047 EL CAMINO REAL STE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582615",
            "telephone_number": "713-321-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIKELY",
        "first_name": "RANDI",
        "middle_name": "BLACKMON",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@backedbyblackmon.com",
            "affiliation": "N",
            "address_1": "17047 El Camino Real Ste 140",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770582615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "LIKELY",
            "middle_name": "B.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.