Kiersten Randall, OTR/L

Key facts

NPI

1588055396

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

U1-0001950 (DE)

Practice address

423 Goodwick Dr
Middletown, DE 19709-0188

Phone

(908) 472-5099

NPI assigned

Feb 16, 2015

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Occupational Play Pediatric Occupational Therapist · Middletown, DE · NPI 1386286920
  NPD Authorized official
• Occupational Play LLC Occupational Therapist · Middletown, DE · NPI 1235772872
  NPD Authorized official OCCUPATIONAL THERAPIST
• Where the Heart Is Home Care In Home Supportive Care Agency · Plainfield, NJ · NPI 1538968581
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 10, 2019.

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1588055396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 GOODWICK DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197090188",
            "telephone_number": "908-472-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 GOODWICK DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197090188",
            "telephone_number": "908-472-5099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 The Grn Ste B",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199013618",
            "country_code": "US",
            "telephone_number": "908-472-5099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "KIERSTEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00592800",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DE",
            "license": "U1-0001950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Middletown, DE · Occupational Therapist in Delaware