Randy Whiteside Prosthetics LLC

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

RANDY WHITESIDE PROSTHETICS LLC

Practice address

1190 E Missouri Ave Ste 190
Phoenix, AZ 85014-2736

Phone

(602) 596-1040

Fax

(480) 212-5944

NPI assigned

Oct 2, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Randall Whiteside, CPNPI 1871017137

Title

Manager

Phone

(602) 596-4010

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall Scott Whiteside, CP

  • Prosthetist
  • Phoenix, AZ
  • NPI 1871017137
  NPD (past) Authorized official

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1609386853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 E MISSOURI AVE STE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142736",
            "telephone_number": "602-596-1040",
            "fax_number": "480-212-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E MISSOURI AVE STE 190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142736",
            "telephone_number": "602-596-1040",
            "fax_number": "480-212-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY WHITESIDE PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-596-4010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Richard Randol, D.M.D
• Lisa Marie Randol, COTA/L
• Adam Charles Randolph, M.D.
• Kelli Randon
• Randy Brazie MD PLLC
• Michelle Raney
• Rebecca Range, CRNA
• Meghan Rangel, LPN
• Rachael Rangel
• Brittany Jo Ranger, BA

• Prosthetist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Prosthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.