Byron Randall Jr., CPRP

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

6340 Security Blvd
Gwynn Oak, MD 21207-5173

Phone

(410) 912-4460

NPI assigned

May 2, 2021

Last updated

Oct 26, 2021By 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

Practice roles

Locations

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.

• Marathon Community Wellness. Inc.

  • Community/Behavioral Health Agency
  • Gwynn Oak, MD
  • NPI 1487238960
  NPD Authorized official

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1558944108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE B34",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "443-912-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "410-912-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "BYRON",
        "name_suffix": "Jr.",
        "credential": "CPRP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-10-26",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pretti Ricki Healing Hands LLC (Ricki Health Services)
• Tonia G Price
• Promptcare Transportation Service Maryland LLC
• Stephanie Pulsinelli, BT
• Sakirat Bukola Raheem, FNP-BC
• Reflections Counseling & Consulting
• Refresh Pain and Wellness, LLC
• Renace LLC
• Kelly Nicole Richardson, LCSW-C
• Robinson Entities LLC

• Community/Behavioral Health Agency in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.